Theoretical foundations and practical implementation of monitoring the accessibility state of ­facilities and services in the field of health care

Abstract

Background.By decision of the Commission under the President of the Russian Federation for the Disabled, the Ministry of Labor of Russia was entrusted with monitoring the implementation of federal and regional action plans road maps to increase the accessibility of facilities to people with disabilities.
 Aim.Monitoring the implementation by state authorities of the constituent entities of the Russian Federationof action plans (road maps) to increase the values of accessibility indicators for disabled people in healthcare facilities.
 Material and methods.The indicators of accessibility for disabled people of facilities in the healthcare system based on the results of implementation of action plans by executive authorities of 85constituent entities of the Russian Federation in the field of healthcare, obtained as a result of monitoring the achieved values in the indicators of accessibility for disabled people of facilities in 2019 and 2020, were analyzed. The availability of facilities was calculated on the basis of information from the state authorities of the constituent entities of the Russian Federation, prepared in accordance with the recommendations of the Ministry of Labor of Russia, using the analysis and generalization of the received materials, using the method of comparing absolute and relative indicators.
 Results.The accessibility of medical organizations for the disabled is created in two ways from the standpoint of universal design (inclusion of measures to organize the accessibility of facilities and services for the disabled when designing and building new facilities, as well as during reconstruction and major repairs) and using the principle of reasonable accommodation for existing facilities (before their overhaul and reconstruction). Ranking the indicators of the e150domain (design, nature of design, construction and arrangement of buildings for public use) on the basis of a unified assessment scale of the International Classification of the Functioning of Disabilities and Health made it possible to identify regions of the Russian Federation with varying degrees of accessibility of healthcare facilities: absolutely accessible in 10(11.8%) regions of the country; with a significant levelof accessibility in 53(62.4%) regions; with a moderate level of accessibility in 8(9.4%) regions; with a low or insignificant level of accessibility in 9(10.6%) regions of the Russian Federation; with a very low levelof accessibility of healthcare facilities in 5(5.8%) regions of the Russian Federation, respectively.
 Conclusion.According to the monitoring of the state of accessibility of facilities for the disabled in the healthcare sector in the constituent entities of the Russian Federation, the level of accessibility varied from 100% to 0.5%. The planned indicators of increasing the availability of facilities in the healthcare sector have reached 100% in 52constituent entities of the Russian Federation.