Issue: 2016, Vol. 21, No. 2
THE PECULIARITIES OF HEALTH CARE MANAGEMENT IN ALMOST INACCESSIBLE SETTLEMENTS IN RUSSIA: SOCIOLOGICAL ANALYSIS
- Keywords
- sociological inquest, Altai Republic, risk factors, aboriginal population, medical aid organization, health care
- Abstarct
- Objective - to determine the factors which influence the work quality of medical treatment facilities in almost inaccessible settlements and to find the means to improve medical aid administartion. Materials and methods. Specialists of the Ministry for Health Care of Altai Republic and medical workers of Novokuznetsk State University for Postgraduate Medical Education performed sociological inquest in 145 rural settlement residents of Choy district of Altai Republic in 2012; their own developed questionnaire was used. Results . Diagnostic possibilities of physician assistant&obstetrician center are limited due to lower level of professional skills of their medical workers in comparison with physicians; admission to hospital is performed in emergency cases only taking into consideration the cause of bed ratio economy. That’s why the patients in the treatment course are forced to visit central district hospital for several times. But 70% patients were obliged to waste nearly 4 hours in order to visit central district hospital so 17,8% did not visit central district hospital at all, 15,6% patients visited central district hospital one time per year; 35,6% patients visited it from 2 to 5 times per year and only 24,4% patients visited it more than 5 times per year. Besides one should take into account the fact that rural residents with serous diseases continued to waste a lot of strength and time for domestic needs. All these factors resulted in fragmentary and unsystematic treatment and it was conducive to the disease chronic course. In connection with the above mentioned facts it would be expediently to organize medical community nursing service; its specialists from local residents should be prepared to render necessary assistance in domestic and medical care needs, to keep the administered treatment. The authors recommended to create the specialized division affiliated to the Ministry of Health Care of Altai Republic; and this division would control the activity of the mobile medical units and it would allow to improve the quality of the treatment in the population of almost inaccessible regions, to provide its prophylactic medical examination in full and the possibility of medical sociological monitoring, to render methodical aid to the personnel of physician assistant&obstetrician centers and medical community nursing services, to solve the problems of medicaments provision in these settlements, to increase the possibilities of telecommunication means in the process of consultations. Conclusions . The remoteness of central district hospitals and the lack of financial means for transport in rural residents, the limitations of physician assistant&obstetrician center possibilities and central district hospital bed ratio and specific mode of life in rural residents were the basic factors which impacted the quality of medical aid administration in almost inaccessible settlements. It was suggested to organize local medical community nursing services and mobile medical divisions in order to improve medical aid organization.
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