According to the authors, transformations in medicine in modern Russia are characterized by the transition to the market of medical services, which is considered as one of the causes of a relative status inflation, a decline in the prestige of the profession of a doctor. The discrepancy in the activity and status of this professional group is a determinant moment. Modern process of institutionalization of medicine is realizing in the change of the status and the marginalization of social-professional groups of the Institute of Medicine. In the opinion of the authors the process of marginalization of doctors is explained by the «concept of status inconsistency» proposed by G. Lensky.
Chronic diseases, which form the somatic and social deprivation of patients, imply the provision of integrated medical and social care. National health care systems are actively pursuing processes aimed at overcoming the fragmentation of health care delivery and forming a model of integrated health care. The purpose of the study. Analysis of interaction of medical organizations and continuity in the treatment of patients in rural health care in the Saratov region.Material and methods. The authors conducted a comparative sociological study, which involved 319 physicians working in the district medical organizations of the Saratov region. The study was preceded by the construction of the medical and social portrait of the respondents.Results. The majority (73.7 %) of the respondents assessed the degree of continuity of patient care between inpatient and outpatient facilities in the district of the region as average.Conclusion. The study reveals the peculiarities of the organization of medical care for the rural population, which consist in the limited implementation of the principles of continuity in the management of patients, the presence of barriers to digitalization. The analysis of the degree of interaction between doctors when providing medical care to the rural population in inpatient and outpatient conditions reveals the fragmentation of rural and regional health systems.
The problems of medical care organization for the population living in rural areas exist in most countries. The results of Russian and foreign studies show the differences in the availability of medical care for rural and urban populations. The analysis of foreign and domestic sources shows, that increasing the availability and quality of medical care for the rural population must be implemented within the framework of comprehensive programs taking into account the region’s level of socio-economic development and infrastructural features and resource provision of healthcare organizations in rural areas.
BACKGROUND: One of the leading indicators of the social effectiveness of healthcare is the assessment, monitoring, and analysis of the social satisfaction of patients with medical care, which reflect the degree of implementation of a personalized approach of medical care. Patients satisfaction with their interaction with the healthcare system is a result of the main characteristics of the quality of medical care, established by the professional community. AIM: To analyze the satisfaction of consumers of medical services in terms of the accessibility and quality of medical care in regional healthcare facilities. MATERIALS AND METHODS: The study involved 218 doctors from primary healthcare medical organizations in Saratov and 312 doctors from primary healthcare medical organizations in districts of the Saratov region. RESULTS: From the results of the research, we determined negative phenomena in the activity of medical organizations in which the respondents received medical care. Despite the limitation of medical care accessibility for the majority of respondents in the regional healthcare (the absence of the necessary specialists, insufficient technical equipment in the medical organizations, the high cost of medicines unaffordable by patients, and queues), while assessing the satisfaction with medical care in the medical organizations of the region the majority of the respondents (63.8% of respondents in the medical organizations of Saratov and 64.9% in medical organizations of Saratov region) evaluated their satisfaction with medical care positively. CONCLUSION: The explanation of the results obtained is possible in the context of the description by Academician of RAS A.V. Reshetnikov the phenomenon of paradoxical medicine, which appeared in the Russian healthcare literature at the end of the twentieth century.
This study presents the results of the analysis of the satisfaction of doctors in the Saratov region with their professional activities. The study included 594 doctors from state, municipal, and private medical organizations in the region. The social and professional characteristics of the respondents were evaluated. Despite financial deprivation, most of the doctors included in the study expressed satisfaction with their professional activities. The results of this study is possibly explained from the perspective of the phenomenon of paradoxical medicine described by academician A.V. Reshetnikov.
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