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

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Abstract

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.

About the authors

Irina A. Lakman

Bashkir State University

Author for correspondence.
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

Russian Federation

Venera Maratovna Timiryanova

Bashkir State University

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

Galiya Timergazievna Zakiryanova

Bashkir State Medical University

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

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