MEDICAL ORGANIZATIONS AND THEIR STRUCTURAL SUBDIVISIONS LOCATED IN RURAL AREAS
Authors:   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia, Latyshova Alla 
Published: June 2024

Significance. Provision of equal access to health care regardless of the patient's place of residence is a priority direction of the healthcare development. Identification of problems and development of organizational activities to develop medical infrastructure in rural areas are being currently prioritized. As many researchers note, the recent transformations of the healthcare system failed to yield the expected results in rural areas, including to attract and retain health workers. It should be pointed out that issues related to care access in rural areas are also associated with factors that are less dependable upon the healthcare system, namely, ensuring transport accessibility and increasing the socio-economic level of rural life. The presence of these factors requires a special approach to solving problems characteristic of rural areas. In this regard, it is highly relevant to study the provision of rural areas with a network of medical organizations, units, as well as basic resources. The purpose of the study was to conduct a retrospective analysis of medical infrastructure (medical organizations and their structural units) and available basic resources in rural areas in 2016 - 2022. Material and methods. The study used statistical materials “Rural Health Care in Russia” of the Ministry of Health of the Russian Federation and Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation in 2016–2022, prepared using the Medstat program and data extraction from federal statistical observation form No. 30 “Information about a medical organization” on doctor staffing level of medical organizations in the Russian Federation, federal districts and constituent entities of the Russian Federation in 2016-2022. Four constituent entities of the Russian Federation (Donetsk and Lugansk People's Republics, Kherson and Zaporozhye regions) were not included in the analysis. The study used analytical and statistical methods. Descriptive statistics was conducted using the software package Statistica version 13.3. Results. Organization and development of the network of medical organizations in rural areas is carried out with due regard to regional peculiarities. The analysis shows that the infrastructure of medical organizations and their structural subdivisions located in rural areas is being developed due to mobile forms of work, set up of a network of rural outpatient clinics and increasing capacity of polyclinics. Conclusion. The study shows that organization of a network of medical organizations in rural areas has its own peculiarities: specific subdivisions and forms of work of medical specialists are being developed. In Russia, over the last seven years, due to reorganization (consolidation) of the network, the number of independent medical organizations has decreased by 16.2% with an active introduction of mobile forms of work. During the period under study, the number of medical outpatient clinics increased by 10.7%, mobile paramedical and midwifery station and health posts - almost 10-fold and mobile medical teams - by 15.5%. Another important positive aspect is the increase in the planned capacity of outpatient and polyclinic units in rural areas. The established trends suggest a higher access to medical care for rural dwellers. Negative trends have been identified as well: from 2016 to 2022, bed capacity decreased by 9.7%, and the share of buildings in emergency condition and subject to demolition increased from 1.28 to 3.88% or by 2.6 p.p. Scope of application. The study results may be of interest to health administrators, practicing physicians, residents and graduate students of medical universities.