Scientific substantiation of proposals for improving medical care for villagers
Authors:   National Research Institute of Public Health named after N. A. Semashko, Kalininskaya A. A. , Bakirova E. A. ,   National Research Institute of Public Health named after N. A. Semashko, Kizeev M. V. ,   National Research Institute of Public Health named after N. A. Semashko, Lazarev A. V. ,   National Research Institute of Public Health named after N. A. Semashko, Shlyafer S. I. ,   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Balzamova L. A. ,   IPO SBEI «Samara State Medical University» of the Ministry of Health of Russia
Published: June 2023

P u r p o s e o f t h e s t u d y : based on the analysis of the medical and demographic situation and the staffing of the rural population, develop proposals for improving medical care for the villagers. M a t e r i a l s a n d m e t h o d s : statistical, analytical, direct observation. The article used the forms of state statistical observation of the Ministry of Health of the Russian Federation. The results of the actual research. Materials and methods: statistical, analytical, direct observation, the forms of state statistical observation of the Ministry of Health of the Russian Federation were used. R e s u l t s . The rural population in the Russian Federation (2021) is 36,9 million people (25,2% of the country’s population). The proportion of the rural population of working age was 53,8%, which is lower than in Russia as a whole – 56%. A 21-year analysis showed that the birth rate of the rural population increased until 2012, while mortality rates decreased, in 2013 the mortality and birth rates became equal and amounted to 14,5‰ each, in 2020 the death rate increased to 15,4‰ due to the COVID‑19 pandemic. The average (expected) life expectancy of the rural population (70,7 years) is lower than that of the urban population (71,8 years); the indicator for rural men is extremely low (66 years). The overall incidence of the rural population is 1,4 times lower than that of the urban population, 117993,2 and 166901,5‰oo respectively. Primary morbidity is also 1,5 times lower (55082,4 and 83002,2‰oo, respectively). The difference in primary morbidity rates of the rural population in the federal districts (2020) was 1,3 times, in the constituent entities – 8,3 times. The incidence of COVID‑19 in the rural adult population (2020) was 1986,0‰oo, which is 2 times lower than in the Russian Federation as a whole (3913.9‰oo). There was a significant difference in these indicators (by 59 times) in the subjects of the Russian Federation, which can be associated with a lower density of the rural population, low availability of medical care in the countryside, as well as the ambiguity of COVID‑19 coding. For 6 years (2016–2021), the provision of doctors in medical organizations in rural areas in the Russian Federation decreased from 14,8 to 13,6‰o, and of nurses – from 54,6 to 49,3‰o. The number of nursing staff individuals working for feldsher-obstetric station decreased by 12,5%, paramedics – by 9,4%. Given the special importance of paramedical assistance in the countryside, the reduction in the number of paramedics should be considered a negative. C o n c l u s i o n . The unfavorable medical and demographic situation in the countryside requires the development of organizational and managerial decisions aimed at increasing the availability of medical care to the villagers. C o n c l u s i o n s . Proposals have been developed to improve the provision of medical care to the population of rural areas.