REGULATORY AND STAFFING PROBLEMS OF UROLOGICAL CARE PROVIDED TO ADULTS AND CHILDREN IN OUTPATIENT SETTINGS

Abstract

Significance. The regulatory and staffing problems in urological care delivery to adults and children in outpatient settings, combined with the high social significance of diseases of the genitourinary system for the population of different age, potentially threaten successful implementation of the priorities of the state demographic policy. Purpose: to identify problems in regulation and staffing in urological care delivery to adults and children on the outpatient basis in the Russian Federation in 2015-2019. Material and methods. The study used data of the Fedral statistical observation Form No. 30 "Information about a medical organization" for the period 2015-2019. Statistical processing of the study materials was carried out by methods of descriptive statistics. Results. The analysis has identified contradictions in the orders of the Ministry of Health of the Russian Federation, which currently regulate staffing in urological care. The number of full-time and occupied positions of urologists in 2015-2019 decreased, which, coupled with the increased number of individuals, resulted in the increased number of urologists (+3.1%), increased level of staffing of individuals up to 62.9%. At the same time, the part-time coefficient among urologists remained high adding up to to 1.3. In 2015-2019, the number of full-time and occupied positions and individual pediatric urologists-andrologists increased, against the background of extremely low staffing level of individuals equalling to 26.7% in 2019 without any significant dynamics over a 5-year period. The function of the urologist position remained unchanged (4072 appointments per position in 20194 and 4181.3 in 2015), while the function of the pediatric urologist-andrologist position increased from 4215 appointments per position in 2015 to 5342 in 2019 (+ 26,7%). The integral staffing coefficient had a negative trend especially in relation to pediatric urologists-andrologists. Conclusions. The growth in the number of individual urologists and pediatric urologists-andrologists in 2015-2019 did not result in any significant changes in the staffing levels in the urological care delivery to adults and children on the outpatient basis. It is necessary to update the staffing standards, objectify statistical reporting and take urgent measures to bridge the shortage of doctors in outpatient settings. Scope of application. The study results can be used for timely updates of regulatory legal acts, staffing schedules of medical organizations in planning and implementing human resource programs aimed at eliminating personnel shortages and imbalances.