2021 № 4 ABOUT ENSURING STABILITY OF FUNCTIONING OF HEALTH CARE IN EMERGENCY SITUATIONS
The pandemic of COVID‑19 put before society new unique, economic and ethical dilemmas as it imposed increased requirements to health care systems, both on national, and at the global level. One of these problems – ensuring stability of functioning of a health care system in emergency situations.
Research objective – the analysis of the current trends defining ability of health care to satisfy sharply increasing needs of people for medical care at emergence of emergency situation.
Materials and methods. Methods of the content analysis, economical and statistical analysis, information and analytical materials of the Russian and foreign news agencies, statistical materials of the Russian Ministry of Health and Federal State Budgetary Institution TSNIIOIZ of the Russian Ministry of Health , a form of the state statistical observation No. 62, summary across Russia, “Data on resource providing and on delivery of health care to the population”, methods of the content analysis, economical and statistical analysis, information and analytical materials of the Russian and foreign news agencies, expert estimates, analytical materials and statistical data of World Health Organization, statistical data and metadata over the countries of the Organization for Economic Cooperation and Development (OECD) and the certain countries which are not members and also the materials of monographic researches and periodicals including placed on the Internet are used.
Results. At the level of the state, resistance of a national health care system to emergency situations is defined by a condition of infrastructure of the industry, the mechanism and the amount of financing and also scales of attraction of the private medical sector to work for the benefit of society. For 2011–2019 the number of the hospitals of the state form of ownership participating in implementation of the Program was reduced from 4542 in 2011 to 2896 in 2019, or for 37%, and the number of the group hospitals participating in implementation of the Program increased almost by 1.5 times – from 163 organizations in 2011 to 235 in 2019. The number of the medical organizations of emergency medical service of the state form of ownership was reduced from 235 in 2011 to 169 in 2019, and the number of the private medical organizations of emergency medical service participating in implementation of the Program increased from only one organization in 2012 to 28 organizations in 2019. The number of the out-patient and polyclinic institutions of the state form of ownership participating in implementation of the Program was reduced since 2581 in 2011 to 1419 in 2019, or twice, and the number of private out-patient and polyclinic medical institutions increased from 485 organizations in 2012 to 2160 organizations in 2019, or by 4,5 times. At the level of the population stability of health care is affected by social and economic structure of society, ability and readiness of people to pay and be assessed with a tax for payment of medical care. At the same time, the solvency of the population of Russia remains low, and the insufficient amount of financing of health care leads to the accruing substitution guaranteed to medical
care by paid medical services.
Conclusions. In modern Russia there was a trend of increase in number of the private medical organizations which are carrying out activity in the sphere of compulsory health insurance in a combination to decrease in number of the public medical institutions that demonstrates gradual strengthening of a role of private business in questions of providing the population with medical care. It is necessary to guarantee that financing of the private sector at the expense of treasury will be carried out not to the detriment of the state medical organizations and will not undermine the processes which began in the country on system strengthening of health care, first of all – its primary link. For this purpose it is necessary to increase significantly a share of the public expenditures by health care in gross domestic product of Russia.