Study of the impact of available healthcare resources on the population’s mortality rate using the hierarchical linear modelling

Мұқаба

Дәйексөз келтіру

Толық мәтін

Аннотация

Introduction. The uneven development of the medical material and technical base and resources is observed worldwide. At the same time, healthcare resource availability is associated with the territorial characteristics of the population’s mortality rate. In order to reduce mortality, a better understanding of this relationship is needed.

The purpose of the study is to assess the impact of healthcare resource availability on mortality, taking into account the hierarchical nesting of municipalities in subjects of the Russian Federation with further funding for health care and demographic indicators.

Material and methods. For these purposes, hierarchical linear modelling is used. The assessment was carried out on the data of 265 municipalities attributed to 6 constituent entities of the Russian Federation. The data sources are the Territorial Bodies of the Federal State Statistics Service and the Unified Interdepartmental Information and Statistical System (www.fedstat.ru). 

Results. As a result of modelling, the health care resources (doctors, medical personnel, beds) at the municipal level were determined to reduce the population mortality rate positively. At the same time, an ambiguous influence of the actual cost of the territorial compulsory medical insurance program was revealed at the regional level.

Conclusion. The results obtained correspond to studies devoted to the regional diversity of the population mortality rate and the available healthcare resources. However, they make it possible to determine the influence of factors taking into account the level of their formation (regional, municipal). The proposed models make it possible to improve the quality of managerial decision-making in the health care system since, taking into account the hierarchical nesting, they share the influence of regional and local factors on the variation of municipalities in terms of the mortality rate of the population.

Авторлар туралы

Irina Lakman

Bashkir State University

Хат алмасуға жауапты Автор.
Email: lackmania@mail.ru
ORCID iD: 0000-0001-9876-9202

MD, PhD, Head, Laboratory for the study of socio-economic problems of regions, Bashkir State University, Ufa, 450076, Russian Federation.

e-mail: lackmania@mail.ru

Ресей

Venera Timiryanova

Bashkir State University

Email: noemail@neicon.ru
ORCID iD: 0000-0002-1004-0722
Ресей

Galiya Zakiryanova

Bashkir State Medical University

Email: noemail@neicon.ru
ORCID iD: 0000-0003-0774-5366
Ресей

Әдебиет тізімі

  1. Ivashinenko N.N., Korchagina I.I., Migranova L.A. Population health and accessibility of medical services in Russian small towns. Sotsiologicheskiy almanakh. 2013; (4): 427–39. (in Russian)
  2. Pepelyaeva A.V., Tret’yakova E.A. Structural and functional model of the regional health care system. Vestnik Omskogo universiteta. Seriya: Ekonomika. 2018; (2): 164–76. https://doi.org/10.25513/1812-3988.2018.2.164-176 (in Russian)
  3. Lobkova E.V., Petrichenko A.S. Managing the effectiveness of the regional health system. Regional’naya ekonomika: teoriya i praktika. 2018; 16(2): 274–95. https://doi.org/10.24891/re.16.2.274 (in Russian)
  4. Kalashnikov K.N. Resource security of healthcare in Russia: issues of territorial differentiation. Ekonomicheskie i sotsial’nye peremeny: fakty, tendentsii, prognoz. 2015; (1): 72–87. (in Russian)
  5. Ivanova T.A. Mortality population from the main causes: study of regions of RF. Sistemnoe upravlenie. 2016; (1): 1–16. (in Russian)
  6. Molchanova E.V. Research into the factors influencing the death rate of the population in Russia by means of mathematical statistics methods. Perspektivy nauki. 2011; (5): 73–7. (in Russian)
  7. Ivanov V.N., Suvorov A.V. Issues of health care in Russia. Problemy prognozirovaniya. 2003; 14(3): 280–9.
  8. Chahoud J., Semaan A., Rieber A. Wealth, health expenditure, and cancer: A national perspective. J. Natl Compr. Canc. Netw. 2016; 14(8): 972–8. https://doi.org/10.6004/jnccn.2016.0104
  9. Askarov R.A., Karelin A.O., Lakman I.A., Rozanova L.F., Askarova Z.F. Segmentation of territories of the Republic of Bashkortostan on the level of mortality from malignant neoplasms. Zdravookhranenie Rossiyskoy Federatsii. 2019; 63(1): 4–13. https://doi.org/10.18821/0044-197X-2019-63-1-4-13 (in Russian)
  10. Gurvich V.B., Nikonov B.I., Malykh O.L., Kochneva N.I., Varaksin A.N., Maslakova T.A., et al. The use of regression models in the decision support system for managing public health risk as a result of the impact of socio-economic factors. Ural’skiy meditsinskiy zhurnal. 2008; (8): 26–33. (in Russian)
  11. Boytsov S.A., Samorodskaya I.V. Factors influencing mortality. Vestnik Rossiyskoy akademii nauk. 2016; 86(12): 1089–97. https://doi.org/10.7868/80869587316110037 (in Russian)
  12. Ades F., Senterre C., de Azambuja E., Sullivan R., Popescu R., Parent F., et al. Discrepancies in cancer incidence and mortality and its relationship to health expenditure in the 27 European Union member states. Ann. Oncol. 2013; 24(11): 2897–902. https://doi.org/10.1093/annonc/mdt352
  13. Putrik P., Ramiro S., Moltó A., Keszei A. P., Norton S., Dougados M., et al. Individual-level and country-level socioeconomic determinants of disease outcomes in SpA: multinational, cross-sectional study (ASAS-COMOSPA). Ann. Rheum. Dis. 2019; 78(4): 486–93. https://doi.org/10.1136/annrheumdis-2018-214259
  14. Sapon N.A., Nikiforova A.N. Correlation between access to health care and stroke mortality. Ukraїns’kiy neyrokhіrurgіchniy zhurnal. 2016; (2): 54–62. (in Russian)
  15. Li Y., Wei Y.H.D. A spatial-temporal analysis of health care and mortality inequalities in China. Eurasian Geogr. Econ. 2010; 51(6): 767–87. https://doi.org/10.2747/1539-7216.51.6.767
  16. Herrin J., St. Andre J., Kenward K., Joshi M.S., Audet A.M.J., Hines S.C. Community factors and hospital readmission rates. Health Serv. Res. 2014; 50(1): 20–39. https://doi.org/10.1111/1475-6773.12177
  17. Richardson E.A., Moon G., Pearce J., Shortt N.K., Mitchell R. Multi-scalar influences on mortality change over time in 274 European cities. Soc. Sci. Med. 2017; 179: 45–51. https://doi.org/10.1016/j.socscimed.2017.02.034
  18. Subramanian S.V., Jones K., Duncan C. Multilevel methods for public health research. In: Kawachi I., Berkman L.F., eds. Neighborhoods and Health. New York: Oxford University Press; 2003: 65–111.
  19. Garson D. Hierarchical Linear Modeling: Guide and Applications. New York: Wiley; 2013. https://doi.org/10.4135/9781483384450
  20. Goldstein H. Multilevel Statistical Models. New York: Wiley; 2010.
  21. Smyth F. Medical geography: understanding health inequalities. Prog. Hum. Geogr. 2008; 32(1): 119–27.
  22. Dubovik M.V., Gubarev R.V. Influence of human capital on innovative development of regions. In: Solovev D., eds. Smart Technologies and Innovations in Design for Control of Technological Processes and Objects: Economy and Production. FarEastСon 2018. Smart Innovation, Systems and Technologies. Volume 139. Cham: Springer; 2019: 112–8. https://doi.org/10.1007/978-3-030-18553-4_15
  23. Denisenko M.B., Bakhmetovoy G.Sh., eds. Mortality: Trends, Study Methods, Forecasts [Smertnost’ naseleniya: tendentsii, metody izucheniya, prognozy]. Moscow: MAKS Press; 2007: 256–71. (in Russian)
  24. Pitacco E. Mortality of Disabled People. SSRN: Electronic Journal. 2012. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1992319
  25. Christiansen M.C., Niemeyer A., Teigiszerová L. Modeling and forecasting duration-dependent mortality rates. Comput. Stat. Data Anal. 2015; 83: 65–81. https://doi.org/10.1016/j.csda.2014.09.017
  26. Mackenbach J.P., Karanikolos M., McKee M. The unequal health of Europeans: successes and failures of policies. Lancet. 2013; 381(9872): 1125–34. https://doi.org/10.1016/s0140-6736(12)62082-0
  27. Banin S.A. Russian healthcare: financing issues, ways of improvement. Vestnik Tomskogo gosudarstvennogo universiteta. Ekonomika. 2012; (3): 112–7. (in Russian)

Қосымша файлдар

Қосымша файлдар
Әрекет
1. JATS XML
Жүктеу

© Lakman I.A., Timiryanova V.M., Zakiryanova G.T., 2021

Creative Commons License
Бұл мақала лицензия бойынша қолжетімді Creative Commons Attribution 4.0 International License.
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ:  ПИ № ФС77-50668 от 13.07.2012 г.