[The analysis of medical personnel potential of stomatological service of the Subject of the Russian Federation considering its private sector].

The approaches to analysis of medical personnel of stomatological service continue to be based on principles formed in relation to state health care system that makes it difficult to objectively assess situation due to increasing proportion of specialists employed in its private sector. The study, targeted to comprehensive comparative analysis of stomatological medical personnel of state and private medical organizations in the Irkutsk Oblast, for the first time made it possible to assess provision of population of large region and its municipalities with stomatologists, considering specialists employed in private medical organizations, in dynamics and in context of separate specialties. The decrease in provision of population with stomatologists in state medical organizations by 12.3% in 2019-2023 against the background of its increase in private ones by 14.5% was revealed. In 2023, 50.5% of stomatologists were concentrated in private sector of stomatological service and 30.8% in state sector. Yet another 18.7% combined their work in medical organizations of both types. The stomatologists employed in private sector of stomatological service were mainly concentrated in metropolises, especially in regional center, where their provision exceeds average regional level by 2.6 times.

[The analysis of demand in pathoanatomists applying staff standards].

The objective analysis of state of medical personnel, along with assessment of real need for specialists, is the basis of improving activities of any health care service. In relation to pathologists, there is unique opportunity to perform similar analysis, based on application of current corresponding staff standards that consider volume of workload of physicians in order to determine required number of positions. The implementation of corresponding original methodology permitted to establish that the actual number of staff positions of pathologists in 2022 amounted up to average 40.6% of the number required according to staffing standards in the Irkutsk Oblast. The physician staffing ratio, calculated on the basis of required number of positions found according to proposed methodology, decreases to 29.1% and staffing with physicians excluding combined jobs to 17.1%. At that, implemented workload per one pathologist reaches 5.9 of standard positions. The deficiency of representatives of this specialty in the region, even if current combined jobs ratio is maintained, is 154 specialists.

[The sociological assessment of motives of job placement and professional adaptation of graduates of medical university in primary health care section].

The task of increasing staffing of physicians in primary health care level is resolving by accreditation of medical workers. The sociological assessment of motives of employment and professional adaptation of graduates of medical university who started to work as district therapists and pediatricians after undergoing primary accreditation was carried out. Only about 7% of graduates initially wished to work as district physicians. The most frequent reasons of employment were to get additional points for admission to residency (18%) and need in financial resources (18%). The analysis of professional plans of respondents testifies intention of every second to leave primary medical care to work in specialty received in residency. The seven out of ten respondents noted insufficient scope of necessary clinical knowledge and practical skills, lacking of effective measures for professional adaptation, including internship and supervision.

[The formation of organizational structures coordinating manpower policy in health care of the subject of The Russian Federation].

Nowadays, development of organizational structures coordinating personnel policy in health care of the Subjects of the Russian Federation is relevant. The purpose of the study was to investigate feasibility, scientifically substantiate and implement at the level of the subject of the Russian Federation measures developing organizational structures to coordinate participants of personnel policy in health care. According to 88.5% of interrogated experts, insufficient interaction between participants of personnel policy in health care is a significant cause of problems of medical personnel in the Irkutsk Oblast. About 81.1% of respondents consider overall efficiency of interaction between participants as low. The survey permitted to study main directions and degree of interaction between participants of personnel policy in Oblast health care. At that, 82.8% of respondents indicated that intensification of low interaction requires development of special organizational structure. The obtained results permitted to formulate proposals concerning organization in the Irkutsk Oblast of Medical Council under the Governor and in its structure working group on personnel policy in health care. The corresponding methodological support was developed.

[The analysis of readiness of young specialists to self-dependent work in primary health care section].

At the present time, about 20% of graduates of medical universities after initial accreditation are employed as district physicians. The purpose of the study was to investigate readiness of graduates of medical university to work as district physicians after primary accreditation. The analysis was based on results of sociological survey of immediate supervisors of graduates. The interviewed heads of departments assess as relatively low level of practical training of graduates (3.8 points out of 5) and their readiness to independent work as district physicians (41.2%). The scarcity of implementation of the most effective measures for professional adaptation of novice district physicians, including paid mentoring (5.0%) and internship (1.7%) is established too. According to survey results, for training of district physicians, the most appropriate is to revive such previous forms of training in national system of higher medical education as internship (21.2%) and subordination (50.6%).

[The evaluation of efficiency of accreditation of graduates of medical universities as a measure supporting increase of numbers of physicians in primary health care section].

One of the most important tasks in transition to primary accreditation of health care professionals is increasing manning of primary health care section. It is achievable at the expense of opportunity for graduates of medical universities to find employment as district physicians and pediatricians without residency training. The purpose of the study was to assess impact on increasing of number of physicians of primary health care section of their admission to professional activities after primary accreditation. The study was carried out in the Irkutsk State Medical University provided objective quantitative evaluation of this occurrence. It was revealed that only every fifth graduate in specialty "General Medicine" and "Pediatrics" is employed as district physician, in half of cases combining this work with residency training, that subsequently results in leaving primary health care section. Only one out of ten continues to work in this position during 3-5 years.

[The sociological aspects of medical employee turnover].

The level of development of human resources in health care is determined by a number of factors, among which an important place belongs to turnover of medical staff. The turnover, or the process of unscheduled dismissal of staff, negatively affects functioning of the organization in any field, including health care. Although the analysis of staff turnover is widely applied in various fields of activity, relatively few studies are related to problems of assessing causes of this phenomenon in health care. The purpose of the study was to assess the characteristics and causes of turnover of medical staff in state medical organizations of the Irkutsk Oblast. The detailed information about the respondents obtained in the study made it possible to get a concept of intensity and characteristics of turnover of physicians and medical nurses, and to study causes of dismissal of respondents from their previous employment as well as causes that influenced current employment and to assess content and effectiveness of measures of professional adaptation and social support of hired specialists.

[The evaluation of personnel progression in state medical organizations of the Irkutsk Oblast].

The medical personnel reallocation is the most important resource to ensure sustainable functioning and development of medical organizations and health care system as a whole. The purpose of the study was to assess reallocation of medical personnel of state medical organizations in the subject of the Russian Federation exemplified by the Irkutsk Oblast in 2015-2019. The study permitted to test approaches to application of methods for analysis of reallocation of medical personnel in respect of physicians. The results contribute to development of measures targeted to prevent and to reduce the medical personnel turnover and to increase efficiency of human resources management in health care.

[The Comprehensive Organization of Identification of Tuberculosis in Population of the Eastern Siberian Region].

The early detection of tuberculosis is one of the priority targets in the system of anti-tuberculosis care of population, regardless of epidemiological and socio-economic conditions. The effectiveness of these activities depends on system of organization, methods of detection, quality of planning and implementing preventive examinations for tuberculosis among population. Despite decreasing of morbidity and mortality from tuberculosis in the Irkutsk oblast, it belongs to the territories with high prevalence of tuberculosis. Until 2011, the increasing of incidence of tuberculosis in the Irkutsk region occurred mainly due to increasing of effectiveness of measures of active detection of tuberculosis in population. In 2012-2019, the incidence rate tends to decrease while maintaining appropriate level of efficiency of active detection of disease. In context of improving epidemiological situation of tuberculosis, it is necessary to focus organizational efforts on active detection of tuberculosis mainly in risk groups, with simultaneous increasing of detection of disease in population by referral to medical organizations of primary medical care.

[The comparative evaluation of policy documents of the Russian Federation concerning personnel policy in health care].

Nowadays, in Russia number of problems is present in effective personnel policy in health care. The National Concept of personnel policy in health care (2002) expired in 2010 and no new one was developed. However, corresponding program documents were adopted at the level of subjects of the Russian Federation. The purpose of study was to compare evaluation of program documents of subjects of the Russian Federation related to issues of personnel policy in health care. The continuous sampling technique was applied to study these documents, which were valid in the territories of all subjects of the Russian Federation in 2002-2019. The comparative assessment was performed. It is demonstrated that the most informative document in this area is only the corresponding specialized Concept. However, this document was adopted only in 8.2% of the subjects of the Russian Federation, and they were valid only in two subjects. The concepts of health care development in the subjects of the Russian Federation, addressing medical personnel policy were adopted in 44.7% of the subjects of the Russian Federation. However, these legal documents operate only in 15.3% of territories. At the same time, the availability of appropriate specialized program document is a prerequisite of development of coherent and effective medical personnel policy in health care at all its levels.

[The comparative analysis of training of paramedical personnel on the territory of the subjects of the Russian Federation of the Siberian Federal Okrug].

The comparative analysis of training of nursing staff in the territories of subjects of the Russian Federation, included in the Siberian Federal Okrug was implemented, based on data of the federal statistical monitoring of corresponding educational organizations in 2018. The analysis of calculated indices permitted to identify uncoordinated nature of provision of nursing staff and volumes of its training at the level of number of subjects of the RF on the territory of the Siberian Federal Okrug, and group them according to combination of level of the given indicators. The assessment was implemented concerning validity of manpower policy in the case of nursing staff in territories of mentioned regions. The study results permitted to determine role and place of the analyzed regions in training of nursing personnel considering groups of criteria characterizing training activities, infrastructure of educational organizations, financial economic aspects of implementation of educational process and employment of graduates with nursing education. The mentioned results are the basis for further research on issues of education of nursing staff at the level of particular subjects of the Russian Federation, analysis of indices in dynamics, factors determining level of development of manpower potential of medical organizations and other elements of scientifically grounded manpower policy in health care sector.

[The sociological evaluation of commitment to treatment in re-hospitalized patients].

The article presents the results of sociological assessment of commitment to treatment of repeatedly hospitalized patients in hospitals of the Irkutsk Oblast and the Republic of Buryatia, that permitted to study their medical and social characteristics, the level of awareness of their own health, their diseases and methods of their treatment are presented. Sampling was preceded by the selection of respondents with the support of experts that reduced the impact on the study results of various factors, along with commitment to treatment, which determines the effectiveness of the treatment process (effective treatment methods for the relevant nosology, quality of medical care, etc.). The reasons for re-hospitalization were studied. The factors resulting in incomplete implementation and rejection of medical recommendations, as well as factors contributing to increased commitment to treatment were analyzed. It was established that three out of four respondents are not committed to therapy, respondents were poorly informed about the normal and their own most important indices of their health. Only one out of five of respondents indicated that they comply with medical recommendations in fullness. The main reasons for commitment to treatment are the factors that are managed by the health care system: detailed information about the disease and prescribed treatment, attention given by the doctor to their patients in accordance with their needs.

[On the issue of work time measurement in phthisiatricians rendering ambulatory polyclinic care to adult and children population].

The formation of the number of medical personnel, the establishment of labor standards, the rational distribution and use of personnel are the most significant components of the system of labor rationing in health care. Standard norms of working time for TB doctors are not developed. There is an uneven workload and a plan implementation indicator in different offices and cabinets. The timing of the working process of phthisiatricians providing outpatient care to adults and children was carried out; work time was spent on individual elements of the labor process of district phthisiatricians accepting adults and children and a phthisiatrician without district work receiving patients in the office tuberculosis care for HIV patients. The concept of "visitation" is defined as applied to the working conditions of the TB service. According to the results of time-keeping observations, technological operations performed by TB doctors, including additional sections of work that are not related to the admission of patients, are highlighted; the normative indicator of the function of the medical post of the district TB specialist and the normative indicator of the time spent on one visit are determined.

[The New Approaches to Organization of Medical Supplies Support of Patients in Hospital in Modern Conditions].

The article considers the results of complex scientific analysis of issues concerning medications' support of patients in hospital in modern conditions. The economic and social efficiency of proposed organizational methodological approaches to development of management of medications' support is demonstrated.

[The Medical Economic Analysis of Specialized Ophthalmologic Care within the Framework of Territorial Program of State Guarantees].

The article considers the results of study of economic issues related to application of intraocular lenses in medical organization in modern conditions. The main problems of conformity of possibilities to needs in health care are demonstrated.