Vol 62, No 6 (2018)

The problem of the availability of doctors and nurses is particularly relevant in rural areas. The purpose of the study is to assess the effectiveness of the implementation of the Zemsky Doctor program in the Tyumen Region. To achieve the goal, a number of tasks were solved: analysis of number, composition and movement of program participants; analysis of the impact of the program on the availability of doctors in the rural population; analysis of the reasons for early termination of contracts. Materials and methods. The study was conducted by the Tyumen State Medical University of the Ministry of Health of Russia with the assistance of the Health Department of the Tyumen Region in 2018 on the basis of processing and analyzing statistical data on 520 doctors who participated in the Zemsky Doctor program in the Tyumen Region (without autonomous districts). Results. The main reason for early termination of contracts on the initiative of the program participant is the acquisition of housing in another settlement. The analysis showed that the majority of early termination of contracts falls on recipients of payments in 2012-2014. Discussion. The criterion of effectiveness of the program is the provision of doctors for the population. The analysis led to the conclusion that “Zemsky Doctor” program contributed to the improvement of the rural population’s supply of doctors, at the same time, the annual average growth rate of provision of doctors during the period of the program implementation was 5,7%, the maximum value of the indicator was noted in 2015-2016. Currently, the problem of retaining recruited specialists in rural areas is particularly relevant. Conclusion. The results of study can be used by regional authorities, management of medical organizations when deciding on the further implementation of Zemsky Doctor program, as well as in making managerial decisions on the issues of human resources for rural healthcare generally.

Introduction. Among the problems of health care during the reform period, the problem of quality management of medical care and effective management of the medical organization is particularly highlighted. The purpose of the study is to determine the main priorities of effective management of the medical organization of obstetric and gynecological profile to ensure the proper quality of medical care to the population. Materials and methods. We carried out quantitative and qualitative evaluation of the perinatal center in the period 2015-2017. Studied the efficiency of the administration of the human resources capacity of health organizations quality indicators of the hospital bed Fund and the financial-economic activity of enterprises. Results. The effective activity of the institution in the conditions of the established perinatal center is Shown due to the chosen strategy and tactics of the phased development of new obstetric, neonatal, inpatient-replacement technologies, the provision of highly specialized care with the use of modern equipment and medicines, which allowed to expand the range and volume of Advisory and diagnostic and treatment services, to reduce the level of perinatal and maternal losses. Discussion. The strengths of the organizational activities of the perinatal center management include: the inclusion of women’s consultation in the structure of the perinatal center, ensuring the continuity of care for gynecological and pregnant patients; state social support for motherhood and childhood, changing the conditions and procedure for the provision of free medical care to the population; functioning on the basis of the perinatal center of the Department of pathology of newborns, Department of resuscitation and intensive care of newborns, consultative and diagnostic and gynecological departments. The weak side of the organization can be attributed to the shortage of highly qualified personnel (doctors, nurses and Junior medical staff). Conclusion. In order to effectively use the resources of the institution, it is important to change the approach to the provision of material resources and their rational use in the process of the institution’s activities. The chosen strategy and tactics of management decision-making makes it possible to improve the quality and availability of medical care for pregnant women, mothers, maternity and newborn children.