ORGANIZATION OF MEDICAL CARE IN THE FIELD OF “MEDICAL REHABILITATION” IN THE SIBERIAN FEDERAL DISTRICT

Hightlights

• The theoretical novelty of the presented work is to expand knowledge about the specifics of the organization of medical care in the field of “medical rehabilitation” in the Siberian Federal District during the implementation of territorial programs of state guarantees of free medical care to citizens in the period 2019–2023.

Abstract

Aim. Comparative assessment of the provision of medical care in the “medical rehabilitation” profile provided in the Siberian Federal District (SFD) during the implementation of territorial Programs of state guarantees (TPSG) of free medical care to citizens for 2019–2023.

Methods. The study was carried out on the basis of data posted on the official websites of the Territorial Compulsory Medical Insurance Funds and the executive bodies of state power exercising powers in the field of healthcare. The following indicators were used: the number and organizational and legal structure of medical organizations, average standards of volume and financial costs per unit volume of medical rehabilitation, planned and actual volumes, financial support for medical care in the “medical rehabilitation” profile. A comparative assessment of the studied indicators was carried out using descriptive statistics methods.

Results. During the time period under study, there was an expansion of the conditions for rehabilitation within the framework of the TPSG, rehabilitation measures in the day hospital and outpatient settings were gradually added to the exclusively inpatient care. A steady trend of increasing the number of completed medical rehabilitation cases and their cost over a five-year period has been established. An exception was recorded only in 2021, when restrictions related to coronavirus infection were in effect and planned hospitalization was difficult. The changes in the volume and financial indicators approved by the TPSG of the subjects of the Siberian Federal District were as follows: in 2020, an increase of 24 and 29% (volume and financial support, respectively), in 2021, a decrease of 14 and 10%, in 2022, an increase of 67 and 36%, in 2023, an increase of 50 and 59%. The restriction of the participation of federal medical organizations in the implementation of the TPSG has led to a redistribution of the number of medical rehabilitation cases between organizations of other forms of ownership. During the study period, an increase in the volume and financial support of medical rehabilitation allocated within the framework of the TPGG in the Siberian Federal District was revealed by more than 2.5 times.

Conclusion. The results of the subjects’ fulfillment of planned indicators of the volume of provision and financial support reflect the subject's ability to organize rehabilitation measures. To improve the situation with the provision of medical care in the “medical rehabilitation” profile, work should continue in the following areas: training and retraining of specialists, infrastructure development, increased funding, and harmonization of applicable rehabilitation standards and protocols.

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