Ways to reduce health risks in remote areas of the Russian Federation by improving health and sanitary care

UDC: 
331.45: 613.622
Authors: 

M.F. Vilk1, O.I. Kopytenkova1,2, O.S. Sachkova1, E.A. Zhidkova3

Organization: 

1All-Russian Research Institute of Transport Hygiene of the Federal Service for Surveillance over Consumer Rights Protection and Human Wellbeing, 1 Pakgauznoe Highway, build. 1, Moscow, 125438, Russian Federation
2Emperor Alexander I St. Petersburg State Transport University, 9 Moskovskii Av., Saint Petersburg, 190031, Russian Federation
3Central Healthcare Administration – Branch of the Russian Railways JSC, 52a Malaya Gruzinskaya St., build. 1, Moscow, 123557, Russian Federation

Abstract: 

Healthcare in Russia is facing a serious challenge as the healthcare system needs improvement and any territorial differences in access to healthcare services should be eliminated. Use of a territorial approach to providing healthcare and sanitary services to the population requires solutions that should entail their availability, high quality and low costs.

The aim of this study is to identify promising areas where provision of healthcare and sanitary services can be improved in remote areas of the Russian Federation.

A prototype mobile consultation and diagnostic center Saint Panteleimon has been tested in the operation mode. The center is a train made of railway cars manufactured by the Tver Carriage Works JSC and equipped for providing therapeutic, surgical, ophthalmological and other healthcare services as well as for conducting instrumental research and laboratory tests.

The train followed routes within the Far Eastern and Siberian Federal Districts using the Eastern-Siberian and Zabaikalskaya railways. The total length of the routes was 7065 kilometers; they go through 59 railways stations. It took 86 days (75 of them workdays) to travel these routes completely.

Overall, 9493 diseases were diagnosed in 7263 people who visited the train. Each fourth disease was diagnosed in examined patients for the first time in their lives. Diseases of the circulatory system, endocrine diseases, diseases of the musculoskeletal system, diseases of the eye and adnexa prevailed among those diagnosed in people who applied for healthcare services. One hundred and sixty-two people out of the examined patients were sent to an in-patient hospital. The most common causes for hospital admission included diseases of the musculoskeletal system, neoplasms, diseases of the circulatory system and endocrine diseases. Functioning of railway mobile consultation and diagnostic centers will reduce risks of health losses among population living in remote areas due to available qualified healthcare and sanitary aid, result in longer life expectancy and help preserve active longevity.

Keywords: 
healthcare and sanitary aid, remote areas, railway, consultation and diagnostic center Saint Panteleimon, risk of health loss, locomotive traction carriages, active longevity, low-mobile population groups
Vilk M.F., Kopytenkova O.I., Sachkova O.S., Zhidkova E.A. Ways to reduce health risks in remote areas of the Russian Federation by improving health and sanitary care. Health Risk Analysis, 2025, no. 1, pp. 137–143. DOI: 10.21668/health.risk/2025.1.13.eng
References: 
  1. OECD. Rural Well-being: Geography of Opportunities. OECD Rural Studies. Paris, OECD Publ., 2020. DOI: 10.1787/d25cef80-en
  2. Bekeshova E. Problems in the organization of primary health care for the rural population at the current stage. Byulleten' nauki i praktiki, 2020, vol. 6, no. 1, pp. 145–154. DOI: 10.33619/2414-2948/50/16 (in Russian).
  3. Plutnitsky A.N., Ogneva E.I., Nizamova E.R., Roshchin D.O. Modernization of primary health care in Russian Federa-tion. Aktual'nye problemy meditsiny i biologii, 2022, no. 1, pp. 30–34 (in Russian).
  4. Konshina E.E., Ogneva E.Yu., Savchenko N.A. On the implementation of the program for the modernization of the primary level of the Russian healthcare system. Menedzhment kachestva v meditsine, 2021, no. 1, pp. 4–7 (in Russian).
  5. Sistema zdravookhraneniya: dostupnost', kachestvo, kurs na rezul'tat [Healthcare system: accessibility, quality, focus on results]. Vostochnyi Ekonomicheskii Forum, September 07, 2022. Available at: https://forumvostok.ru/news/sistema-zdravoohranenija-dostupnost-kachestv... (January 08, 2025) (in Russian).
  6. Skipin D.L., Yukhtanova Yu.A., Kryzhanovskii O.A., Tokmakova E.G. Life expectancy in Russia’s regions. Economic and Social Changes: Facts, Trends, Forecast, 2022, vol. 15, no. 2, pp. 156–171. DOI: 10.15838/esc.2022.2.80.10
  7. Andreev E., Shkolnikov V. The relationship between mortality and economic development in Russia and its regions. Demograficheskoe obozrenie, 2018, vol. 5, no. 1, pp. 6–24. Available at: https://demreview.hse.ru/article/view/7707/8548
    (September 28, 2024) (in Russian).
  8. Zhukova A.K., Silaev A.M., Silaeva M.V. Spatial Analysis of Life Expectancy in Russian Regions. Prostranstvennaya ekonomika, 2016, no. 4, pp. 112–128. DOI: 10.14530/se.2016.4.112-128 (in Russian).
  9. Kolosnitsyna M.G., Kossova T.V., Sheluntcova M.A. Factors of the life expectancy increase: country-level cluster analy-sis. Demograficheskoe obozrenie, 2019, vol. 6, no. 1, pp. 124–150. Available at: https://demreview.hse.ru/article/view/9784/10974 (September 28, 2024) (in Russian).
  10. Kossova Т.V. Growth Factors of Life Expectancy in Modern Russia. Voprosy statistiki, 2020, vol. 27, no. 5, pp. 76–86. DOI: 10.34023/2313-6383-2020-27-5-76-86 (in Russian).
  11. Khabriev R.U., Schepin V.O., Mirgorodskaya O.V. The complex evaluation of target indices population health in the Central Federal Okrug of the Russian Federation. Problemy sotsial'noi gigieny, zdravookhraneniya i istorii meditsiny, 2019, vol. 28, no. 3, pp. 349–354. DOI: 10.32687/0869–866X 2020 28 3 349 354 (in Russian).
  12. Rozhkova E.V., Shchukin S.Yu., Kachagin A.A. Health improvement services in Russia: problems and tools to increase accessibility. Finansovyi biznes, 2021, no. 3 (213), pp. 168–171 (in Russian).
  13. Nauryzbayeva A.A., Kyrykbayeva S.S., Kauysheva A.A., Mechshanov G.T. Modern world experience in the de-velopment of approaches to the formation of healthcare personnel policies in rural areas: literature review. West Kazakhstan Medical Journal, 2020, vol. 62, no. 2, pp. 134–146 (in Russian).
  14. Kalininskaya A.A., Bayanova N.A., Kizeev M.V., Balzamova L.A. Assessment of preventable health losses in the rural population. Menedzher zdravookhraneniya, 2022, no. 3, pp. 30–36. DOI: 10.21045/1811-0185-2022-3-30-36 (in Russian).
  15. Kalininskaya A.A., Bayanova N.A. Scientific substantiation of the assessment of the territorial availability of primary medical health care to the rural population. Kazanskii meditsinskii zhurnal, 2020, vol. 101, no. 6, pp. 890–896. DOI: 10.17816/KMJ2020-890 (in Russian).
  16. Pikalova L.V., Ananina O.A., Lazarev A.F., Odintsova I.N., Zhuikova L.D., Kudyakov L.A. Features of the organ-ization of anticancer measures in territories with low population density on the example of the Tomsk region. Rossiiskii onkologicheskii zhurnal, 2017, vol. 22, no. 1, pp. 44–50. DOI: 10.18821/1028-9984-2017-22-1-44-50 (in Russian).
  17. Aksenova E.I., Gorbatov S.Yu. Mezhdunarodnyi opyt obespecheniya dostupnosti meditsinskoi pomoshchi v otdalennoi i trudnodostupnoi mestnosti: Ekspertnyi obzor [International experience in ensuring access to health care in remote and hard-to-reach areas: An expert review]. Moscow, GBU «NIIOZMM DZM» Publ., 2021, 35 p. (in Russian).
  18. CDC. About Rural Health. Centers for Disease Control and Prevention, 2020. Available at: https://www.cdc.gov/rural-health/php/about/?CDC_AAref_Val=https://www.cd... (September 28, 2024).
  19. Rural and Remote Health – Health Status and Outcomes. Australian Institute of Health and Welfare, 2020. Available at: https://www.aihw.gov.au/reports/rural-remote-australians/rural-remote-he... (September 28, 2024).
  20. Kuhn B., Kleij K.-S., Liersch S., Steinhäuser J., Amelung V. Which strategies might improve local primary healthcare in Germany? An explorative study from a local government point of view. BMC Fam. Pract., 2017, vol. 18, no. 1, pp. 105. DOI: 10.1186/s12875-017-0696-z
Received: 
20.12.2024
Approved: 
17.02.2025
Accepted for publication: 
14.03.2025

You are here