DISTRICT PEDIATRIC SERVICE: STAFFING TRENDS IN A LARGE AGRO-INDUSTRIAL REGION
Authors:   Kuban State Medical University of the Ministry of Health of the Russian Federation, Krasnodar, Russia, Redko Andrey , Khan Vladimir ,   Kuban State Medical University of the Ministry of Health of the Russian Federation, Krasnodar, Russia, Martynenko Viktoria ,   Kuban State Medical University of the Ministry of Health of the Russian Federation, Krasnodar, Russia
Published: September 2023

Significance. Timely monitoring over human resources makes it possible to identify reserves for improving accessibility, quality and effectiveness of pediatric primary care delivery. The purpose of the study. To evaluate dynamics in staffing with district pediatricians in the Krasnodar Territory. Material and methods. The material included data of the state statistical observation form No. 30 “Information about a medical organization” in 2010-2021, depersonalized data from the register of the assigned population of the Krasnodar Territory and the regional register of medical workers as of 01.01.2022. Statistical and analytical methods were used. Results. In the Krasnodar Territory there are 76 medical organizations with the position of district pediatrician. The total staffing of the district service with pediatricians equals to 1,307 positions, staffed by 1,071 individuals (81.9%). The estimated deficit between the number of positions and the number of individual district pediatricians is 250 specialists. The share of specialists of the pre-retirement and retirement age is high. During the period under review, against the background of a general decrease in the number of individual doctors in the region by 5.1% (p<0.001), there was a 12.6% (p<0.001) increase in the number of district pediatricians. The growth rate of the pediatric population in the region exceeded the one among individual district pediatricians, resulting in a 6.0% decrease in the population-to-doctor ratio(p<0.001). The undertaken in-depth analysis shows that 34% of the district pediatricians have a 1.5-fold and higher workload than the recommended one. In conditions of excessive workload of district pediatricians, primary care services are provided to about 620,000 children. The mean age of a district pediatrician in the Krasnodar Territory equals to 47 ± 0.3 years, however, about half of all doctors in the analyzed group are specialists of the pre-retirement and retirement age. A combined analysis of the age structure of pediatricians and size of the facility catchment areas shows that 30.8% the of district doctors aged over 60 have a workload that is higher than the recommended standards. Conclusion. A wider range of methods to monitor the population-to-district pediatrician ratio and the use of both traditional and advanced methods of analysis based on the register of the assigned population and the register of medical workers will make it possible to identify problem areas in the industry and promptly meet the changing staffing needs of the district pediatric service. Scope of application. The study results can be used to plan and implement personnel programs aimed at eliminating personnel shortages and imbalances.