Problems of the organization and management of the pulmonological care to the population of the Far Eastern Federal District

Abstract

Aim. The analysis of the main problems of organization and management of medical care for patients with respiratory disrasrs in the Far Eastern Federal District is carried out. It is suggested to optimize and improve pulmo-nological care to the population and increase its effectiveness. Materials and methods . For the organization of the study there were used the methods of structural and comparative analysis, content analysis of scientific literature on the problems of organization and management of pulmonary care, expert evaluation, statistical, sociological and information-analytical methods, databases of the Ministry of Health of the Russian Federation, the Federal State Statistics Service. Results. It has been established that one of the significant regional problems at present time is significant territorial disparities in the provision of specialized pulmonary care for the population with health care resources: medical personnel and bed-care funds. In particular, the differences in the availability of pulmonologists in the region amount to 3.7 times, and by specialized hospital beds by 8.8 times. At the same time, in 3 subjects of the Far Eastern Federal District there are no specialists in the pulmonary profile, and the available bed capacity is mainly concentrated in the health care institutions of urban settlements, mainly in regional centers. Among the defects in the quality of medical care for patients with a pulmonary profile in outpatient conditions, the analysis shows that the main share is not represented by diagnostic errors or treatment defects, but by incomplete examination of patients, whose share is 62.1%, increasing to 76.1% in rural health institutions. The main causes of them are “the lack of necessary conditions” (from 20.2 to 36.8% depending on the nosological forms of pathology and the conditions of medical care) and “incomplete and inadequate examination” (from 16.7 to 56.7%). Conclusion. The analysis of the resource provision of pulmonary care to the population indicates significant regional differences, the extent of which must be taken into account when planning and organizing specialized medical care in order to manage it better. At the same time, current trends cannot ensure equal accessibility and quality of medical care and create certain risks in the provision of the health care system of the constituent entities of the Russian Federation with specialized resources. Consequently, the conditions in which they carry out their work activities, the availability of opportunities for the realization of existing potential and its development play a significant role in ensuring the quality and efficiency of the work of specialists. At the same time, the analysis of expert and sociological assessment of resource provision, the conditions of medical care and the organizational and methodological mechanisms of its management indicates significant reserves that can be used in the organization of medical care for patients with a pulmonary profile at the primary health care level and increase its effectiveness. In this regard, optimization of the medical network and the structure of medical care in modern conditions should be one of the priorities of the regional policy.