Many factors influence the health status of the population, including socio-economic and environmental parameters and the activities of the health care system.
OBJECTIVE
To assess the associations between medical and organizational indicators and overall mortality depending on the socioeconomic and environmental deprivation of the regions of Russia.
MATERIALS AND METHODS
Medical and organizational indicators for 2010—2019 were taken from the Federal State Statistics Service and the Russian Research Institute of Health’s statistical collections. Overall mortality rates for 2010—2019 were also taken from the Federal State Statistics Service’s statistical compilations. Negative binomial regression with moderation effect was used to establish the relationship between medical and organizational indicators and mortality (absolute values).
RESULTS
An association of several healthcare indicators with overall mortality, including a positive one with the number of in-hospital organizations (MRR 1.018; 95% CI 1.017—1.019; p<0.001) and a negative one with the average length of stay of a patient per year (MRR 0.846; 95% CI 0.795—0.900; p<0.001) were found. When analyzing this association with the inclusion of the deprivation factor, it was found that the association in regions with different levels of deprivation may differ. In the most deprived regions (regions with deprivation values above –0.16), an increase in the number of doctors of all specialties (per 10 thousand population) reduces the number of deaths. An increase in the number of general practitioners (per 10 thousand population) in the most deprived territories (regions with deprivation values more than 0.15) also reduces the number of deaths.
CONCLUSION
The results of our study indicate the importance of considering socioeconomic factors and geographical living conditions to analyze the association of mortality with the characteristics of the healthcare system, as well as the importance of considering deprivation when developing regional programs of medical and preventive care and resource support for the regional healthcare system.
