Scientific substantiation of the assessment of the territorial availability of primary medical health care to the rural population

Abstract

Aim. To assess the territorial accessibility of primary health care (PHC) to the rural population in the Orenburg ¬region. Methods. Statistical, monographic, organizational experiment research methods were applied. Statistical proces¬sing was carried out by using the Statistica 10.0 software. Basic statistics were calculated (arithmetic mean, weighted arithmetic mean). All parameters were checked by using Shapiro–Wilk, Kolmogorov–Smirnov and Lilliefors tests for normal distribution. The parametric method of statistics (Student's t-test) was used. Results. The assessment of the territorial accessibility of primary medical health care to the population of the Orenburg region was carried out using the methodology developed by us for calculating the criteria for the accessibility of primary medical health care to the rural population “Rating of medical organizations according to the criterion of territorial accessibility of primary medical care to the rural population”. The use the methodology allows ¬making management decisions regarding the territorial planning of primary health care for the rural population in the selection of problem areas with low accessibility of primary medical care. In the Orenburg region, there are the following problems: different levels of accessibility of primary health care with a variety of distance up to 30 km and different population sizes in settlements create difficulties in organizing the provision of primary health care; remoteness from the regional center up to 300 km forms a personnel deficit. Conclusion. Application of the methodology “Rating of medical organizations according to the criterion of territorial accessibility of primary medical care to the rural population” in the Orenburg region has allowed the development of the following recommendations for making management decisions at the regional level: (1) prioritization of territories for priority measures to ensure the availability help; (2) selection of the form of primary health care organization for the timely medical care provision to the population; (3) the formation of competition among medical organizations in the ranking of the availability of primary health care.