Medical and sociological assessment by physicians of the availability of medical care for chronic diseases in rural healthcare in the region: A cross-sectional focus group study

Abstract

BACKGROUND: Problems with the organization of medical and medicinal care for populations living in rural and remote areas exist in most countries. In the context of Russia, this problem has been discussed in studies over several decades.The doctor as a subject of medicine more often acts as an object of medical and sociological research in the context of their medical (expert) knowledge about the representatives of different social groups of patients. The uniqueness of the research conducted is determined by the focus of the research interest on the social group of doctors in the context of their health problems, i.e., on the study of the personal patient experiences of rural health doctors.
 AIM: To study the problems of access to medical care by rural health professionals in the region.
 MATERIALS AND METHODS: Eight heads of departments of district medical organizations of the Saratov region took part in the focus group study. The participants suffered from chronic diseases (for more than 10 years), and two respondents attended a disability group.
 Following the guidelines of the focus group study, the discussion covered issues of the accessibility of medical care by physicians with chronic diseases in medical organizations of the region and directions for improving access to medical care by healthcare professionals.
 The data obtained were evaluated according to the standard requirements for the analysis of qualitative data with the support of the discourse analysis methodology.
 RESULTS: The results highlighted the key issues reflecting the problems of accessibility of medical care to rural healthcare specialists. The empirical material gathered added to the range of problems assumed at the stage of planning and the description of the peculiarities of obtaining medical care by the chosen group of respondentsdoctors in rural healthcare.
 CONCLUSION: The analysis of the array of respondents opinions of the focus group research allowed several conclusions to be reached. In the context of rural healthcare, access to medical care for physicians has not only an organizational but also a social and geographical context;moreover,the barriers are the staff deficits in rural healthcare, the lack of necessary infrastructure and material and technological backwardness of rural healthcare, the lack of transport provision in the region, and the mentality of the inhabitants of rural areas. In a situation where physicians with chronic health problems need help, the above list of barriers is supplemented by a high level of workload and the specific self-preservation behaviors of representatives of this group.