Внутрирегиональное неравенство в сфере здравоохранения: Дальний Восток России накануне пандемии COVID-19

Abstract

The study presents an assessment of inequality in the healthcare sector of the Russian Far East, which formed in the period 2010–2019, on the eve of the pandemic of a new coronavirus infection (COVID-19). In contrast to the common approach in the scientific literature to the study of inequality in the field of medical services and medical care based on subjective assessments (surveys) of the population, in this article the problem is solved by analyzing the array of panel data of official statistics (Rosstat) for eleven subjects of the Russian Federation as part of the Far Eastern Federal District (FEFD), including data on cities (capitals and large centers) and a set of other settlements, allocated in each region. The comparative intra-regional dynamics of indicators characterizing population and mortality changes, the quality and accessibility of medical care (infrastructure and staffing) in the regions of the Far Eastern Federal District in the context of large cities and other settlements are analyzed. It has been established that in the Far East, intra-regional inequality in the healthcare sector is systematically maintained in terms of resource and staffing, when not only residents of other settlements, but also individual large cities are in the most vulnerable position. It is shown that on the eve of the pandemic, a significant part of the population of other settlements of the Far Eastern Federal District found itself in a situation of territorial inaccessibility of medical care or the availability of low-quality medical infrastructure with high wear and tear in the absence of a sufficient number of ambulances and a shortage of professional personnel. The conclusion about the crisis of the intra-regional healthcare systems of the Far East in the pre-pandemic period is substantiated