ОЦЕНКА ДОСТУПНОСТИ МЕДИЦИНСКОЙ ПОМОЩИ В ПЕРИОД ПАНДЕМИИ ИНФЕКЦИИ COVID-19 НА ТЕРРИТОРИИ КРАСНОЯРСКОГО КРАЯ

Abstract

Significance. The introduction of various restrictive measures at the beginning of 2020 to prevent the spread of COVID-19 infection contributed to a decrease in the planned volumes and availability of medical care for the population. The purpose of the study is to assess availability of primary health care and specialized medical care during the COVID-19 pandemic for the assigned population of the Krasnoyarsk Territory. Material and methods. The study covered the period from 2012 to 2021 and was conducted in the Krasnoyarsk Territory within the catchment area of the Federal Siberian Research and Clinical Center of the FMBA of Russia, including catchment areas in the city of Krasnoyarsk and in the closed territorial-administrative unit Zelenogorsk (Clinical Hospital No. 42). The study material was the information from the federal statistical observation forms (No. 12, No. 30). Changes in primary care availability at outpatient settings and specialized medical care in inpatient settings in the pre-COVID period (from 2017 to 2019) and the period of the COVID-19 pandemic (2020-2021) were analyzed. Results. In 2020, the overall disease incidence decreased by 8.0% compared to the long-term average in the pre-COVID period from 2012 to 2019 equaling to 2148.3 cases per 1000 population. The primary incidence added up to 792.9 cases per 1000 population, which is 7.9% lower than the pre-pandemic level. There was a decrease in the doctor-to-population ratio from 24.3 per 10 thousand population in the pre-pandemic period to 21.8 per 10 thousand population in 2021, and from 26.8 per 10 thousand population down to 25.2 per 10 thousand population (Clinical Hospital #42). During the pandemic, there was a decrease in the rate of visits per resident per year within the catchment area of the Federal Siberian Research and Clinical Center from 10.2 visits in 2017-2019. to 7.8 per resident in 2020-2021, and from 9.6 to 8.15 visits per resident per year within the closed administrative territory. During the pandemic, the structure of visits changed, the number of visits for illnesses within the catchment area of the Federal Siberian Research and Clinical Center decreased by 22.7%, the number of preventive visits decreased by 16.4%, and by 25.4%, and 17.4 % respectively within the closed administrative territory. During the pandemic, 39.5% of the total number of beds were repurposed as an infectious disease hospital to provide care for patients with the new coronavirus infection, primarily beds allocated to pulmonary care (55.9%), beds for rehabilitation (29.0%), beds allocated to cardiac care (36.4%), beds allocated to therapeutic care (28.6%). As a result of a set of organizational measures and a number of management decisions, in 2021, there was a positive trend in resuming availability of primary health care and specialized care for the population. Conclusion. The COVID-19 pandemic has significantly affected availability of primary health care and specialized medical care, highly contributed to the change in the structure of care seeking at the outpatient level and planned hospital admission rate. The complex of implemented organizational measures contributed to better performance of medical organizations, higher availability of medical care, and more effective management of the hospital bed fund.