Primary care physicians: performance indicators in the Russian Federation and federal districts for 2010–2019

Abstract

BACKGROUND: The organization of outpatient care has undergone various transformations in the past 20 years, with the main being the development of a new outpatient clinic model and the introduction of a general practitioner in replacement of a primary care physician.
 AIM: This study aimed to assess the performance of primary care physicians in the Russian Federation and federal districts (FD) from 2010 to 2019.
 MATERIALS AND METHODS: Based on data from the Federal Statistical Observation Form No. 30 Information on a Medical Institution, the performance indicators of primary care physicians in the Russian Federation and FDs from 2010 to 2019 were calculated and analyzed.
 RESULTS: During the study period, the function of physicians position in the Russian Federation remained almost unchanged (0.2%) and amounted to 5060.4 visits per physician per year in 2019, whereas the FDs showed multidirectional changes ranging from +13.1% in the Southern FD to 9.3% in the Central FD. In the Russian Federation, a decrease in both the total number of visits to primary care physicians per 1000 adults (16.2%, from 1983 to 1661.9) and outpatient visits (8.9%, from 1642.7 to 1496.4) and a simultaneous decrease in the share of home visits from 17.2% to 10.0% (41.9%) were observed. In the structure of outpatient visits, a decrease in visits for diseases (16.5%, from 84.7% to 70.8%) was registered, whereas the share of preventive visits doubled (from 15.3% to 29.1%). In contrast, regarding the structure of home visits, the share of visits for diseases increased, whereas the share of preventive visits decreased.
 CONCLUSIONS: The described processes may be explained by reforming the polyclinic model with an emphasis on strengthening the role of general practitioners and the gradual replacement of primary care physicians.