Accessibility of medical care in the public and private sectors of healthcare (based on the results of a sociological survey of the population of the Vologda region)

Introduction. In the Vologda region healthcare there are complex management and economic (acute shortage of doctors) and spatial (large territory, complex settlement system) restrictions on the availability of medical care. The private health sector is an alternative to the public sector, but it expands the burden of public spending. This actualizes research aimed at assessing the availability of medical care in both sectors of the industry.

Purpose of the study. Assessment of the availability of medical care for the population of the Vologda region  in the public and private sectors.

Materials and methods. The toolkit is a questionnaire survey of the population (sample consisted of 1,500 people) conducted in the region in 2018 and 2020. The analysis is carried out by means of the distribution of respondents’ estimates, expressed in specific weights of the total amount of responses, in the comparative context of demographic and territorial groups, the public and commercial sectors of the industry. The integral index of accessibility of medical care is proposed and tested.

Results. Respondents estimate the availability of medical care/services in private medical institutions higher than in public ones (the accessibility index (AI), in 2020 was 179.6 and 163.4, respectively). During the study period, the index increased, but the gap between sectors remained. The lowest subjective estimates of accessibility were received by medical care in rural areas (AI for the public sector — 167.8, private — 179.5) and in Cherepovets (AI accounted of, respectively, 148.1 and 151.4). The highest level of accessibility was found in small towns (AI was 177.6 and 194.8).

Limitations. When studying the availability of medical care in the region, 1,500 questionnaires were evaluated, which represents a sufficient reference sample to solve the tasks set.

Conclusion. The study allowed obtaining valuable results, which, along with the developed tools (in particular, the index of accessibility of medical care), are recommended to the authorities for monitoring the situation in the healthcare of the region.

Compliance with ethical standards. The sociological survey underlying the study was voluntary. A positive conclusion was received from the Expert Commission of the Vologda Scientific Center of the Russian Academy of Sciences (dated August 12, 2022), established to conduct an examination of materials for open publication.

Acknowledgment. The reported study was funded by the RFBR (project number 20-010-00852 А).

Conflict of interest. The authors declare no conflict of interest.

Received: August 15, 2022
Accepted: December 15, 2022 
Published: July 06, 2023