Abstract
The article presents the results of a qualitative analysis of the influence of exclavity and the level of income of the population on the consumer preferences of patients in the medical services market using the Kaliningrad region as an example. Economic disparity in access to healthcare services contributes to the psychographic stratification of healthcare consumer preferences. Territorial isolation from the country and the proximity of foreign countries leave an imprint on the social and economic life of the population of an exclave subject and commitment to medical tourism. M a t e r i a l s a n d m e t h o d s . In the period from September to November 2022, a one-time comparative study of consumer preferences for choosing a country and a medical organization in the medical services market of 773 working-age residents of the Russian Federation was planned and conducted. All respondents were stratified into two groups according to their place of residence: residents of the Central Federal District and the Kaliningrad Region. The groups were comparable in terms of gender and age. Methods used: open online survey, qualitative analysis, statistical. The significance of differences in the percentages of the trait was estimated by the Fisher angular transformation coefficient (φ) with a given confidence level of 95%. R e s u l t s . The influence of exclavity and income level on consumer preferences for choosing a medical organization has been established. The features of the priority motivators for the choice of public, private or foreign medical services of the respondents of the Kaliningrad region are revealed. The comfort of receiving medical services (“lack of queues”) was 1,4 times more likely to motivate the choice of private medicine among respondents in the Kaliningrad region compared to respondents in other regions. The demand for the services of private and foreign clinics in the exclave territory is proportional to the level of income. Medical tourism services were used by 28,7% of respondents from the exclave territory who prefer private medicine. C o n c l u s i o n . A distinctive feature of consumers of medical services in the exclave Kaliningrad region is the increase in demand for private medicine and treatment abroad in proportion to the increase in income levels. Respondents from the exclave territory are 1,4 times more likely to choose private clinics and 23,9 times more likely to use medical tourism services compared to residents of the Central Federal District. Every fourth respondent in the Kaliningrad region does not trust the quality of training of doctors in the Russian Federation. Transport accessibility of the EU countries, dissatisfaction with the level of training of medical personnel, the lack of a number of medical services in the Russian Federation, the ability to realize the desire to combine treatment with a trip abroad with a sufficient level of income of the population in the exclave region, along with a shortage of medical personnel in the subject, contribute to increasing the attractiveness of private medical organizations, import of medical services and outflow of patients abroad. Recommendations are given to increase the attractiveness of state medicine in the exclave territory.
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