2022 № 7 Analysis of morbidity and staffing of the population of rural areas in the Russian Federation
Rural health care is the most important socio-economic resource in the system of the agrarian economy.
Purpose of the study. Based on medical and demographic indicators and analysis of morbidity and staffing of the rural population, develop proposals for improving the organization of medical care for rural residents.
M a t e r i a l s a n d m e t h o d s : analytical, statistical, direct observation. The article used the forms of federal statistical observation of the Ministry of Health of the Russian Federation.
R e s u l t s . The mortality rate of the rural population over the 20 years of analysis for all the years has been and remains higher than that of the urban population. In 2020, there was a sharp increase in the mortality of the population: urban – from 11,9 to 14,3‰, rural – from 13,3 to 15,4‰, which is associated with the COVID‑19 pandemic. The indicators of the general and newly diagnosed morbidity of the rural population are lower than those of the urban population, which is associated with the low availability of medical care to the rural population.
The ranking of indicators of the general incidence of the rural population in the federal districts of the Russian Federation (2020) showed that the difference in indicators was 1,5 times. The highest indicator was noted in the Volga Federal District – 142220,6‰00, the lowest in the Far Eastern Federal District – 96922,8‰00. In the subjects of the Russian Federation, the difference in indicators is 8 times. Lower rates of primary morbidity in the rural population than in the urban population were noted for all classes of diseases. The incidence of COVID‑19 among rural residents was 2151,9‰00, lower than in urban areas – 4539,5‰00, in the Russian Federation the figure was 3384,5‰00. In 2020, the primary morbidity rate of the rural population decreased for all classes of diseases, except for respiratory diseases. In dynamics (2014–2020), the provision of medical organizations located in rural areas increased with doctors from 12,1 to 14,0‰0, with nurses from 44,4 to 50,3‰0, the number of physical EMS persons decreased by 14,8%, paramedics – by 11,6%, the number of FAPs and AFs decreased by 8,9%. The analysis shows that the Decree of the Government of the Russian Federation dated 02.02.2015 No. 151-r “Target indicators of the strategy for sustainable development of rural areas of the Russian Federation for the period up to 2030” is not being implemented.
C o n c l u s i o n . Proposals for providing medical care to the population of rural areas are presented
2022 № 10 Features of the organization of work of paramedical personnel of emergency medical care in the conditions of COVID‑19
In recent years, the ambulance service in our country has been undergoing changes in the direction of reducing the number of stations, medical personnel, as well as persons who have been assisted on trips, which has increased the burden on this healthcare sector in the context of the spread of a new coronavirus infection.
The purpose of the study is to develop proposals to improve the organization of the work of the ЕMС in the conditions of the spread of a new coronavirus infection.
Materials and methods. To study the organization of work, information was copied from call cards (n=134 before the
pandemic, during the pandemic n=2058), the study of the frequency and validity of ЕMС calls was carried out using a developed questionnaire.
Statistical processing of the material was carried out using the Statistika 10.0 software package. Statistical differences were considered significant at p<0.05.
Results and discussions. It was found that in the conditions of the spread of a new coronavirus infection, the number of calls and the time spent on their full processing increased, and factors affecting the duration of the call were also identified. In addition, an increase in the number of unreasonable calls was detected and their causes were determined.
Findings. The developed proposals for improving the work of the ЕMС will reduce time losses when making a call and increase public awareness of the reasons for calling an ambulance
2023 № 3 Scientific substantiation of proposals for improving medical care for villagers.
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.