Osmanov E M, Reshetnikov V A, Kagramanyan I N, Tatarchenko V V, Manyakov R R, Prokopov A Yu, Blinova A I, Zhigalko T A, Abdullaev A Ao
The Federal State Autonomous Educational Institution of Higher Education "The I. M. Sechenov First Moscow State Medical University" of Minzdrav of Russia (Sechenov University), 119991, Moscow, Russia,
The State Budget Institution "The Tambov Oblast Children Clinical Hospital", 392000, Tambov, Russia.
Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2024 Nov;32(6):1296-1305. doi: 10.32687/0869-866X-2024-32-6-1296-1305.
The most acute problem of state health care system is shortage of medical personnel, both physicians and paramedics. The purpose of the study is to assess dynamics of personnel support with otolaryngologists in medical organizations of the Russian Federation for 2018-2023. The retrospective analytical descriptive study was carried out using continuous method based on studying dynamics of personnel support with otolaryngologists in the Russian Federation in general, Federal Okrugs and particular Subjects of the Russian Federation for 2018-2023. The calculation of dynamics of population provision with otolaryngologists per 10 thousand of population and dynamics of the number of otolaryngologists in medical organizations of state and non-state ownership was carried out. In the Russian Federation, level of population provision with otolaryngologists in 2018-2023 decreased from 0.62 to 0.61 per 10 thousand of population/ In some Subjects this indicator increased and in others decreased that testifies existence of internal labor migration of specialists. The largest increase in the number of otolaryngologists was established in Moscow, Moscow Region, St. Petersburg, Kaliningrad Oblast and Sakhalin Oblast and some other Subjects, the most attractive ones in terms of salaries, work conditions, social guarantees and other privileges. Besides, taking into account the number of otolaryngologists working in both state and non-state medical organizations, their number in the Russian Federation in 2018-2023 increased from 13,222 to 14,548 specialists. At the same time, there is significant outflow of otolaryngologists into non-state medical organizations. In 2018, the percentage of otolaryngologists working in non-state medical organizations made up to 20.8% and in 2023 28.3%. The three regions with the lowest level population of provision with otolaryngologists in 2023 were the Jewish Autonomous Region (0.2 per 10 thousand of population), the Republic of Khakassia (0.36 per 10 thousand of population) and the Kurgan Oblast (0.39 per 10 thousand of population). The three Oblasts with highest level of population provision with otolaryngologists are the Republic of North Ossetia-Alania (1.09 per 10 thousand of population), the Chukotka Autonomous Okrug (1.05 per 10 thousand of population) and St. Petersburg (1.03 per 10 thousand of population). It is established that, despite slight decrease in population provision with otolaryngologists in 2018-2023, their labor migration to regions with higher level of social economic development, as well as outflow to non-governmental medical organizations within the region continued to take place. The manpower policy currently implemented in the Russian Federation regarding medical workers brought no expected results. The results demonstrated imbalance in provision with otolaryngologists and different levels of their deficiency in particular regions that emphasizes importance of individualized and comprehensive approach to personnel provision in each region.
国家医疗保健系统最严峻的问题是医务人员短缺，包括医生和医护人员。本研究的目的是评估2018 - 2023年俄罗斯联邦医疗机构中耳鼻喉科医生的人员支持动态。该回顾性分析描述性研究采用连续方法，基于对2018 - 2023年俄罗斯联邦整体、联邦区以及俄罗斯联邦各主体中耳鼻喉科医生的人员支持动态进行研究。计算了每万名人口中耳鼻喉科医生的配备动态以及国有和非国有医疗机构中耳鼻喉科医生数量的动态。在俄罗斯联邦，2018 - 2023年每万名人口中耳鼻喉科医生的配备水平从0.62降至0.61。在一些主体中该指标上升，而在另一些主体中下降，这证明了专家存在内部劳动力迁移。耳鼻喉科医生数量增加最多的是莫斯科、莫斯科地区、圣彼得堡、加里宁格勒州和萨哈林州以及其他一些主体，这些地区在薪资、工作条件、社会福利和其他特权方面最具吸引力。此外，考虑到在国有和非国有医疗机构工作的耳鼻喉科医生数量，2018 - 2023年俄罗斯联邦的耳鼻喉科医生数量从13,222名增加到14,548名专家。与此同时，耳鼻喉科医生大量流向非国有医疗机构。2018年，在非国有医疗机构工作的耳鼻喉科医生比例为20.8%，2023年为28.3%。2023年耳鼻喉科医生配备水平最低的三个地区是犹太自治州（每万名人口0.2名）、哈卡斯共和国（每万名人口0.36名）和库尔干州（每万名人口0.39名）。耳鼻喉科医生配备水平最高的三个州是北奥塞梯 - 阿兰共和国（每万名人口1.09名）、楚科奇自治区（每万名人口1.05名）和圣彼得堡（每万名人口1.03名）。研究表明，尽管2018 - 2023年耳鼻喉科医生的人口配备略有下降，但他们仍持续向社会经济发展水平较高的地区进行劳动力迁移，并且在本地区内流向非政府医疗组织。俄罗斯联邦目前实施的关于医务人员的人力政策并未带来预期效果。结果表明耳鼻喉科医生的配备存在不平衡，且在特定地区存在不同程度的短缺，这凸显了在每个地区采取个性化和综合的人员配备方法的重要性。
