Actual issues of staffing of primary health care by district paediatrician on the example of the region of the Russian Federation

Abstract

Introduction. Eliminating the personnel shortage in medical institutions that provide primary health care (PHC) to children is one of the priority tasks of the state policy in healthcare. The purpose of the work was to assess the impact of changes in the system of training medical personnel and measures to provide primary care medical personnel, implemented in the Volgograd region, on the availability of PHC for children in 2016-2018. Material and methods. According to the data of Central Research Institute of Healthcare Organization and Informatization and Volgograd Regional Medical Information and Analytical Centre analyzed the indices of provision, staffing of district paediatricians, coefficients of concurrency and the level of availability of PHC to the children’s population. Results and discussion. The number of district paediatricians in medical institutions of the Volgograd region from the period 2016-2018 increased by only 46 people with the graduation of 356 specialists from Volgograd State Medical University, which led to a slight increase in the provision of district paediatricians. At the same time, the staffing rate for pediatric sites and the average number of visits per child decreased from 7.9 to 7.6 cases. The studied indices vary significantly in urban and rural medical institutions. There is a high proportion of pre-retirement and retirement age specialists in the village. Twenty-eight district paediatricians participated in training under the “Zemsky Doctor” program, but some left for various reasons. Conclusion. The presence of pronounced differences in the indicators of provision of paediatricians by district doctors in the number of visits per 1 child between cities and municipal districts indicates significant differences in the availability of medical care. It requires organizational measures to overcome this kind of inequality. Admission to work through the primary accreditation procedure in the speciality “Pediatrics” and the implementation of the program “Zemsky Doctor” have not significantly eliminated the personnel deficit at the primary level.