НАУЧНОЕ ОБОСНОВАНИЕ ФОРМИРОВАНИЯ СТРУКТУРЫ ПОЛИКЛИНИКИ ЦРБ

Abstract

Significance. The existing personnel imbalance in health care, including the number of medical staff and occupied positions in the central district hospitals (CDH) of the constituent entities of the Russian Federation and structural units of these hospitals, makes it difficult to improve availability and quality of primary health care (PHC). Development and implementation of the standard CDH models with the standard staffing table, on the basis of which it is possible to form the optimal structure of the central district hospital with the optimal staffing table based on the justified need for human resources, will contribute to improving quality and availability of primary health care at the municipal level. Purpose of the study: to significantly substantiate the regular number of medical personnel of the central district hospital with differently sized catchment areas. Material and methods: Forms of the federal statistical observation (FSN) No. 30 in the pilot territories in three constituent entities of the Russian Federation in the three different federal districts, procedures for care delivery by specialty. Analytical and statistical methods. Results. Actually, a doctor position should be included in the CRH staffing table if the standards allow for the full-time position. Certain health specialties allow for part-time positions if the outpatient and inpatient positions of the specialists can be combined into one full-time position, or part-time positions in the related specialties in the polyclinic with due regard to the population demand. Results. The structure of the CDH polyclinic and the list of full-time medical positions considerably differ depending on the size of the attached population. The adequate number of specialty doctors is ensured by the CDH work organization, distribution of specialists across separate subdivisions that are part of the CDH structure, and the use of telehealth technologies.