Organizational and economic factors of assessing the management of accessibility and quality of medical care in the Republic of Tatarstan

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Abstract

BACKGROUND: Today, when assessing the availability and quality of medical care, objective criteria and indicators prevail, and the factor of patient feedback as end consumers is practically not taken into account, which does not allow us to form a comprehensive view and get closer to solving this problem.

AIM: To identify the factors that have the greatest impact on patients' assessment of the availability and quality of medical care, to study the influence degree of organizational and economic problems of medical organizations on this assessment and to develop quantitative indicators for managing this indicator.

MATERIAL AND METHODS: The study was conducted using a questionnaire from October to December 2023 based on medical organizations of the Republic of Tatarstan. Two types of questionnaires were compiled. The first questionnaire was for consumers of medical care, covering 2,419 patients of hospitals and clinics from all cities and districts of the Republic of Tatarstan. The second questionnaire was for medical personnel. A total of 20,330 medical workers took part in the survey: 5,206 doctors, 10,841 nurses, 4,283 junior medical personnel from all types of medical organizations, including central republican hospitals, city and district hospitals and clinics of Tatarstan. The results of the questionnaires were processed by means of correlation and regression analysis using the least squares method.

RESULTS: It was revealed that for patients of medical organizations the most significant factors in assessing the quality of medical care were: (1) queues and constant waiting (50.5% of respondents); (2) inability to see a specialist (48.9%); (3) unavailability of diagnostic procedures (biochemical blood test, computed tomography and magnetic resonance imaging, ultrasound; 40.7%); (4) inattention, indifference of medical workers (27.5%). Factors in the work of medical institutions and personnel that had the greatest impact on patients' assessments of the indicator of availability and quality of medical care were identified: stress at work, overload and high work pressure, dissatisfaction with salary. The regression coefficients of the identified factors allow them to be used as indicators of management decisions aimed at increasing the importance of availability and quality of medical care.

CONCLUSION: Patient assessments obtained by medical organizations as a result of feedback allow not only to bring the level of availability and quality of medical care as close as possible to the expectations and needs of patients, but also to identify areas of management influence to improve it.

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About the authors

Marsel M. Minnullin

Ministry of Health of the Republic of Tatarstan

Email: Marsel.Minnullin@tatar.ru
ORCID iD: 0000-0001-9761-003X
SPIN-code: 3615-1110

MD, Cand. Sci. (Med.), Minister

Russian Federation, Kazan

Oleg G. Bodrov

Kazan (Volga Region) Federal University

Author for correspondence.
Email: bodrov7@yandex.ru
ORCID iD: 0000-0003-4322-6053
SPIN-code: 1049-0726

Cand. Sci. (Econ.), Assoc. Prof., Depart. of Economic Theory and Econometrics, Institute of Management, Economics and Finance

Russian Federation, Kazan

Rezeda A. Bodrova

Kazan State Medical Academy — branch of the Russian Medical Academy of Continuous Professional Education

Email: bodrovarezeda@yandex.ru
ORCID iD: 0000-0003-3540-0162
SPIN-code: 1201-5698

MD, Dr. Sci. (Med.), Assoc. Prof., Head of Depart., Depart. of Rehabilitation and Sports Medicine

Russian Federation, Kazan

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Supplementary files

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2. Fig. 1. Rating of satisfaction with the quality of medical care abroad and in Russia [6]

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3. Fig. 2. Expectations of medical workers for salary growth (%)

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4. Fig. 3. Workload of medical staff

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5. Fig. 4. Reasons for working more than 1 rate

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6. Fig. 5. The main causes of staff problems with management; ЭМК — electronic medical record

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