Medical and sociological assessment by physicians of the availability of medical care for chronic diseases in rural healthcare in the region: A cross-sectional focus group study

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access


BACKGROUND: Problems with the organization of medical and medicinal care for populations living in rural and remote areas exist in most countries. In the context of Russia, this problem has been discussed in studies over several decades.The doctor as a subject of medicine more often acts as an object of medical and sociological research in the context of their medical (expert) knowledge about the representatives of different social groups of patients. The uniqueness of the research conducted is determined by the focus of the research interest on the social group of doctors in the context of their health problems, i.e., on the study of the personal patient experiences of rural health doctors.

AIM: To study the problems of access to medical care by rural health professionals in the region.

MATERIALS AND METHODS: Eight heads of departments of district medical organizations of the Saratov region took part in the focus group study. The participants suffered from chronic diseases (for more than 10 years), and two respondents attended a disability group.

Following the guidelines of the focus group study, the discussion covered issues of the accessibility of medical care by physicians with chronic diseases in medical organizations of the region and directions for improving access to medical care by healthcare professionals.

The data obtained were evaluated according to the standard requirements for the analysis of qualitative data with the support of the discourse analysis methodology.

RESULTS: The results highlighted the key issues reflecting the problems of accessibility of medical care to rural healthcare specialists. The empirical material gathered added to the range of problems assumed at the stage of planning and the description of the peculiarities of obtaining medical care by the chosen group of respondents—doctors in rural healthcare.

CONCLUSION: The analysis of the array of respondents’ opinions of the focus group research allowed several conclusions to be reached. In the context of rural healthcare, access to medical care for physicians has not only an organizational but also a social and geographical context;moreover,the barriers are the staff deficits in rural healthcare, the lack of necessary infrastructure and material and technological backwardness of rural healthcare, the lack of transport provision in the region, and the mentality of the inhabitants of rural areas. In a situation where physicians with chronic health problems need help, the above list of barriers is supplemented by a high level of workload and the specific self-preservation behaviors of representatives of this group.

Full Text

Restricted Access

About the authors

Maria G. Yeremina

Razumovsky Saratov State Medical University

ORCID iD: 0000-0001-9752-1352
SPIN-code: 9205-0670

MD, Cand. Sci. (Med.); Applicant of the Department

Russian Federation, Saratov

Irina L. Krom

Razumovsky Saratov State Medical University

Author for correspondence.
ORCID iD: 0000-0003-1355-5163
SPIN-code: 4854-1094

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saratov

Vera G. Subbotina

Razumovsky Saratov State Medical University

ORCID iD: 0000-0002-6626-0791
SPIN-code: 3629-6100

MD, Cand. Sci. (Med.); Associate Professor

Russian Federation, Saratov

Tatiana P. Lipchanskaya

Razumovsky Saratov State Medical University

ORCID iD: 0000-0002-7755-1834
SPIN-code: 5698-6429

MD, Cand. Sci. (Med.); Associate Professor

Russian Federation, Saratov

Marina V. Vlasova

Razumovsky Saratov State Medical University

ORCID iD: 0000-0002-5813-4154
SPIN-code: 4939-6247

Cand. Sci. (Soc.); Associate Professor

Russian Federation, Saratov


  1. Reshetnikov AV, Prisiajnaia NV, Reshetnikov VA, Litvinova TM. The perception of value of health and healthy life-style by the faculty of medical universities. Sociology of Medicine. 2017;16(2):82–90. (In Russ). doi: 10.18821/1728-2810-2017-16-2-82-90
  2. Pogosova NV, Isakova SS, Sokolova OY, et al. Occupational Burnout, Psychological Status and Quality of Life in Primary Care Physicians Working in Outpatient Settings. Kardiologiia. 2021;61(6):69–78. (In Russ). doi: 10.18087/cardio.2021.6.n1538
  3. Reshetnikov AV, Achkasov EE, Reshetnikov VA, et al. Formirovanie zdorovogo obraza zhizni studencheskoi molodezhi. Moscow; 2017. (In Russ).
  4. Lebedeva-Nesevrya NA, Tsinker MY, Chigvintsev VM. Macro-social determinants and public health risks in Russia’s regions. Economic and Social Changes: Facts, Trends, Forecast. 2014;5(35):193–205. (In Russ). doi: 10.15838/esc/2014.5.35.17
  5. Basareva VG. Rural poverty as a factor limiting the innovative development of agro-industrial complex. AIC: economics, management. 2021;3:77–84. (In Russ). doi: 10.33305/213-77
  6. Pokrovsky NY, Shilova VA. Dynamics of Human Capital in Rural Settlements of Russia: Problems of Preservation and Development. Sociologicheskaja nauka i social’naja praktika. 2020;8(4):183–198. (In Russ). doi: 10.19181/snsp.2020.8.4.7664
  7. Musin IT. Sovershenstvovanie upravleniya kachestvom dovrachebnoi meditsinskoi pomoshchi sel’skomu naseleniyu. Kazan’: KGMU; 2005. (In Russ).
  8. Rubtsova VN. New challenges to the healthcare in the socio-economic space of rural areas. Science review: Theory and Practice. 2018;8:147–158. (In Russ).
  9. Kalininskaya AA, Muftakhova AV, Bayanova NA, et al. Health condition of a rural population living in different areas of medical aid accessibility. Manager of Health Care. 2019;8:55–61. (In Russ).
  10. Yerugina MV, Krom IL, Shmerkevich AB, et al. The availability of medical care as an obligatory social health predictor of the population in Russia (review). Saratov Journal of Medical Scientific Research. 2016;12(2):101–105. (In Russ).
  11. Petrov GS, Krom IL, Erugina MV. The accessibility of nephrological care as a predictor of chronic diseases of kidneys. Sociology of Medicine. 2019;18(2):74–77. (In Russ). doi: 10.18821/1728-2810-2019-18-2-74-77
  12. Khazov MV, Romanov SV, Abaeva OP, Murygina MM. The importance of the aspects of the medical staff’s social structure for personnel management in multipurpose public health institution. Public Health and Health Care. 2015;45(1):62–66. (In Russ).
  13. Yurova IYu, Andriyanova EA, Fedorova LM, et al. The problem of health saving among rural population of modern Russian society. Fundamental Research. 2014;7-5:1065–1069. (In Russ).
  14. Ruzhenskii VI. Rol’ meditsinskogo obsluzhivaniya v ukreplenii sotsial’nogo zdorov’ya sel’skogo naseleniya. Collection of Conference Materials «Okhrana sotsial’nogo zdorov’ya sel’skogo naseleniya»; 2017 June 08–10; Ivanovo, Russia. (In Russ).
  15. Zhang D, Son H, Shen Y, et al. Assessment of changes in rural and urban primary care workforce in the United States from 2009 to 2017. JAMA Network Open. 2020;3(10):e2022914. doi: 10.1001/jamanetworkopen.2020.22914
  16. Ikeda Y, Fujiwara H, Sasaki M. Is there a difference between urban and rural areas in the disposal of home medical care waste? 13 years of nation-wide repeated cross-sectional study in Japan. Journal of Material Cycles and Waste Management. 2021;23(1):323–329.
  17. Kirby JB, Yabroff KR. Rural – Urban Differences in Access to Primary Care: Beyond the Usual Source of Care Provider. Am J Prev Med. 2020;58(1):89–96. doi: 10.1016/j.amepre.2019.08.026
  18. Katrak H. Measuring the shortage of medical practitioners in rural and urban areas in developing countries: a simple framework and simulation exercises with data from India. Int J Health Plann Manage. 2008;23(2):93–105. doi: 10.1002/hpm.871
  19. Panova LV. Access to Healthcare: Russia in the European Context. The Journal of Social Policy Studies. 2019;17(2):177–190. (In Russ). doi: 10.17323/727-0634-2019-17-2-177-190
  20. Erugina MV, Krom IL, Ermolaeva OV, et al. Modern problems of the organization of health care to rural population. Modern problems of science and education. 2016;5:76. (In Russ).
  21. Vankov DV, Dyakov SV, Ivanova MA. Telemedical technologies at the present stage of health development. Current problems of health care and medical statistics. 2020;3:223–235. doi: 10.24411/2312-2935-2020-00069
  22. Reshetnikov AV. The social institution of medicine. Part II. Sociology of Medicine. 2018;17(2):68–79. (In Russ). doi: 10.18821/1728-2810-2018-17-2-68-79

Copyright (c) 2023 Eco-Vector

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № 77 - 12391 от 19.04.2002 г. 
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия
ЭЛ № ФС 77 - 80649 от 15.03.2021 г.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies