Results of targeted employment of health workers in urban and rural areas.

Abstract

Targeted training of future medical workers and their guaranteed employment is one of the state measures to address the issue of the shortage of specialists. The key mission of targeted training is the balanced regulation by the organization of training and employment. Currently, there are not enough scientific studies on the results and effectiveness of this measure in the health care system, but many researchers emphasize the problems of targeted employment of medical workers. According to the studies of a number of authors, the imperfection of normative legal regulation of issues of targeted training allows graduates not to fulfill the obligations of employment in medical organizations upon graduation [3–9]. The purpose of the study. Conduct an analysis of indicators reflecting the specifics of targeted employment of health workers in organizations located in urban and rural areas in 2022 and 2023. Materials and methods. The study used statistical data for 85 constituent entities of the Russian Federation on the basis of an operative documented request to the health protection authorities of the constituent entities of the Russian Federation, containing information on the number of employed doctors and nursing staff within the framework of targeted training, as well as the planned values of targeted employment in accordance with the concluded contracts. The study period is 2022 and 2023. The total data on targeted employment of medical workers after completion of the specialty program and completion of residency in the context of the names of positions of doctors and nursing staff were analyzed. Analytical and descriptive statistics methods were used in the research process. Results. The share of doctors and nursing staff employed after completion of targeted training from the total number of medical workers in organizations located in rural areas is higher than the share of those recruited to work in urban medical organizations. On average, 1.3% of doctors and 0.21% of nursing staff are annually recruited to urban medical organizations as part of targeted employment out of the total number of the respective key medical personnel as of the end of the reporting year. In rural areas, these figures are 2.6% and 0.30%, respectively. Specialists are predominantly employed in urban medical organizations, while in rural areas – district doctors. The study revealed that in 2023 there were 128.1 target recruitments per 10,000 doctors in urban areas in a given year, and in 2022–124.8, i. e. the intensity of employment by target recruitment in urban areas increased by 2.6% in two years. In rural areas, there were 260.2 target recruitment admissions per 10,000 physicians in 2023 and 262.8 in 2022, that is, the intensity of target recruitment employment of physicians in rural areas decreased by 1% in two years. When analyzing the indicator comparatively, it is noted that in rural areas it is almost twice as high as in urban areas. Conclusions. Targeted employment of medical workers is an effective and efficient measure to attract medical personnel to organizations experiencing a shortage of them. The analysis has shown that the intensity rate of targeted employment per 10,000 physicians in urban areas of the country is lower than in rural areas, which amounted to 128.1 and 260.2, respectively. According to the results of the last two years, 60% of the doctors planned for targeted employment fulfilled their obligations, including 50% in rural areas. The main reason for the current level of employment is the failure to meet the planned indicators of targeted admission to training due to the violation of obligations by students and graduates, which requires the development of a special methodology for assessing the reasonable formation of the plan for targeted recruitment to educational organizations in the context of each medical organization. When comparing the number of vacant positions of doctors and the number of employed graduates within the framework of targeted recruitment, a significant range of the indicator among the subjects of the Russian Federation was revealed, which is presented in the interval from 1 to 29% (9.0±15.95). In this regard, it can be assumed that the number of persons employed under targeted recruitment does not depend on the additional demand for doctors and does not cover the existing deficit.