MODERN PROBLEMS OF PERSONNEL POLICY IN HEALTHCARE

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Relevance. The problem of staffing health care is one of the most popular and still unresolved issues for a long time [1]. From year to year, it is becoming an increasingly relevant subject of attention. For several decades, there has been an increase in applicants who have chosen the profession of a doctor for their future, but statistics show that only 60% of graduates of medical universities associate their lives with medical practice [2].The purpose of the study. To consider the branches of workforce development that are based on social guarantees and are oriented towards the convergence of the interests of the employee and health care institutions in order to achieve a high result of work to preserve the health of the population.Materials and methods. The data of the Research Institute of the Organization of Health Care and Medical Management, official statistics: ROSTAT, and the Central Research Institute of the Territorial Body of the Federal State Service of State Statistics for the Voronezh Region (Voronezhstat) were used.Results. In the first half of 2019 the number of medical personnel in the Central Federal District decreased by 3.5 thousand people. In the Voronezh region, this figure was 451 medical workers (1.4%). In the first half of 2020, this figure was 2.8 thousand people[3]. Some areas were not included in this statistic, as there was a small increase. These are the Oryol, Kaluga, Tula, and Moscow regions. If we consider the number of doctors per 10,000 population, this indicator decreased by 3.04%. The number of average staff per 10,000 people decreased by 1.8%. There is an increase in individual medical specialists (in total +5.45%) - dermatovenerologists and surgeons [4, 5]. Due to the current situation in the country, the targets regarding the provision of healthcare personnel, which were planned for 2020-2023, will not be achieved.A meeting on the shortage of personnel was held in the Voronezh region on 26.08. 2021. During this event, issues such as measures of social support for medical workers were raised in order to reduce the number of vacancies. At the same time, the department still has a lot of work to do to optimize the regulatory framework in terms of forming a quota for targeted admission, taking into account the real needs of the region, to improve the functioning of continuing medical education.First of all, it should be noted that most students after graduation doubt their qualifications and believe that they do not have the necessary knowledge and practical skills for the management and treatment of patients. In this regard, the state has begun to more actively provide financial support at the expense of the funds raised for the implementation of the approach to practical training.So, using the example of our university (N.N. Burdenko VSMU), I would like to briefly tell you what conditions students have now, in order not only to receive, but also, no less important, to consolidate all practical knowledge and skills. Most of the disciplines have the necessary equipment that meets international standards.It was revealed, after working on these devices in the conditions of the existing simulation center, certainly, the level of knowledge and skills of the students of the N.N. VSMU. Burdenko became taller.It should be stated that in modern conditions it is necessary to change the personnel policy in the health care system, by transferring it to a new quality.In order to increase the influx of medical personnel after graduation into practical healthcare, the Ministry of Health of the Russian Federation has improved about 200 standard educational programs in the main areas of medical activity, as well as 95 federal state educational standards for training doctors in residency. According to this form, more than 7000 people were trained in 2019 and this number is growing every year.In order to create optimal and favorable conditions for doctors, a specialized federal program "Zemsky Doctor" has been operating since 2012, which consists in attracting employees with higher medical education. According to the current rules, financial assistance in the amount of 1 million rubles is provided.And every year this program undergoes a number of modifications.Despite the measures taken, the situation with a shortage of personnel remains one of the most urgent at this time. During the specialized conference of Russian physicians held in the fall of 2019, the following data were announced:- almost 500 settlements with a population of up to two thousand . people are unable to provide first aid services in inpatient facilities; - the shortage of junior medical personnel is more than 130,000 people;- the shortage of doctors is more than 250,000 people;- the total figures for non-closed vacancies exceed 50% of the approved staffing table.In order to increase the effectiveness of the Zemsky Doctor program in 2020, it was decided to eliminate age restrictions (previously, specialists from 25 to 50 years old could use the program).The relevant amendments were confirmed by a special Government Decree No. 1347 dated 18.10.2019 . The federal budget plans to allocate additional funds (more than 237 billion rubles). R.) for targeted financing of medicine.It is impossible not to mention the difficult epidemiological situation that developed by the end of 2019, due to the spread of a new coronavirus infection. Against this background, the state has established special payments to medical workers involved in COVID-19 conditions.Among other things, a targeted training program is being actively conducted in our country, with the help of which more applicants get the opportunity to study on a budget basis, and a medical organization, in turn, is guaranteed to receive a qualified specialist with an increasing shortage of personnel.You can get the target direction in several cases:By contacting the personnel department of the medical institution directly.Contact the university and find out, which organizations he cooperates with in the framework of targeted training.Contact the territorial division of the Ministry of Health of the Russian Federation.However, according to the results of the admission campaign 2020 - the number of places for targeted training has been reduced. Organizations have incurred excessive costs for replenishing medicines, expanding beds, providing doctors with PPE and other expenses. On average, the share of target students in universities decreased by 1/3, and the share of places for targeted delivery of doctors decreased by 12%. Competitive selection has become much more difficult.According to the source of the Ministry of Health website:Since January 1, 2021, new rules for targeted education in universities have come into force. The document is designed for six years (Resolution No. 1681 of October 13, 2020) and has a number of innovations:- equal responsibility for the employment of graduates is introduced for organizations of all types, including educational ones; - state authorities of a particular region agree on the number of budget places allocated for the region or region for targeted training.As for the percentage distribution of places allocated to target groups in 2021, it is determined by a separate document (Order No. 3161-r of November 28, 2020). Taking into account the possibilities of today, a special emphasis is placed on the training of medical personnel. In particular, training in the residency of some narrow specialists, such as (anesthesiology-resuscitation, pathological anatomy, forensic medical examination, traumatology and others) is fully carried out only according to quotas.Conclusion. It is necessary to develop the human resources of medical organizations using an integrated approach. In this regard, the issues of training specialists whose skills and abilities meet the high requirements for modern medicine, in particular, in such a complex epidemiological situation that has arisen at this stage of time, come to the fore.It is important to clearly understand what level of employees are needed by a medical institution both in terms of professional training and in order to form a team as a team. The head of a medical organization needs new competencies, among which is the ability to form a team of like-minded people. We must not forget that one of the main tasks of a manager is to have highly qualified employees in his structure, therefore it is necessary to develop new approaches to teaching all the necessary skills. Work with increasing staff motivation lies in the sphere of building long-term factors: a system of goals, a favorable atmosphere in the team, conditions for professional growth. In the working conditions of health care workers associated with emotional stress, a special role should be given to the system of non-material incentives for personnel.And as a result, it is necessary to create as many programs as possible in the structure of the Russian Federation to motivate the involvement of all potential healthcare personnel.

About the authors

A I Vecherina

Voronezh State Medical University named after N.N.Burdenko

Email: arinavech@gmail.com
ORCID iD: 0000-0003-2688-2489
Russian Federation, 394036.Russia Address: Voronezh region, Voronezh, STUDENTSKAYA str., 10.

A A Zakharcheva

Voronezh State Medical University named after N.N.Burdenko

Author for correspondence.
Email: zakharcheva15@gmail.com
ORCID iD: 0000-0001-5016-4431
Russian Federation, 394036.Russia Address: Voronezh region, Voronezh, STUDENTSKAYA str., 10.

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