SPATIAL-MATHEMATICAL METHODS IN STUDYING THE AVAILABILITY AND ACCESSIBILITY OF PRIMARY HEALTH CARE TO THE POPULATION OF CHUVASHIA

Abstract

The study is devoted to the spatial analysis of the availability and accessibility of primary health care to the rural population of the Chuvash Republic as of January 1, 2024. In the framework of this research, all residents of settlements were equated to rural population, with the exception of those living in urban districts at the time of the study. The assessment was carried out in three stages, covering staffing-related aspects, geographic accessibility, and aggregate evaluation of primary health care availability and accessibility (the aggregate indicator). The matrix method was used in the analysis to calculate the indicators of each stage. For greater clarity, health-care districts were divided into ‘central’ and ‘peripheral’. The assessment of staffing-related aspects took into account not only the number of specialist doctors but also their workload according to disease profiles as well as the prevalence of diseases in accordance with the international statistical classification of diseases and related health problems (ICD-10). When assessing geographic accessibility, the main indicator is the time it takes to reach a health institution providing the necessary specialized care. This indicator was chosen due to its greater information value compared to distance since it takes into account both the quality of the road surface and the features of the terrain. The aggregate indicator is obtained by combining the indicators related to staffing and geographic accessibility. Data on the medical organizations’ territorial coverage, on the composition and size of the population attached to them were obtained from the Ministry of Health of the Chuvash Republic.