Реформа российского здравоохранения 2011–2016 гг. в оценках представителей врачебного сообщества: стратегии, тактики, риски

  • Сания Бояркина
Ключевые слова: health care reform, power strategies, formal norms, administrators’ and physicians’ tactics, risk production

Аннотация

This article analyses social processes associated with the modernization of health care and the optimization of health care facilities that cause not only manifest but also latent consequences leading to a change in the organizational environment and becoming a source of health risks. The author used a content analysis of the materials at the Internet portal for the health care workers published from 2011 to 2016. The author analyzed the events of the news feed on changes in the regulatory framework in the field of healthcare and working conditions in health facilities, and the comments of health workers containing information on the problems that arise in regional health facilities during the reform. The results of the study show that the consequences of the reform, such as the bureaucratization of medical activities, staff shortages, including those caused by excessive dismissals, and overloads not corresponding to wages, have become most relevant for medical workers. Being a translator and interpreter of norms, the administration of health care facilities has the ability to compensate or enhance these effects, becoming a factor that determines the conditions of the organizational environment and the behavior of medical workers. In general, the results suggest that the development of standards at the highest levels of government and their implementation at regional health care facilities are accompanied by tension in the organizational environment, worsening working conditions of medical personnel, and contribute to the formation of sources of institutionally and organizationally produced risks.

Литература

Baudrillard J. (2013) Simulyakry i simulyaciya [Simulacra and Simulation]. Tula: Tul'skij poligrafist Publ. (in Russian).

Bek U. (2000) Obshchestvo riska: na puti k drugomu modern [Risk Society: Towards a New Modernity]. Moscow: Progress-Tradiciya Publ. (in Russian).

Borisov V.A. (2001) Social'noe partnerstvo v Rossii: specifika ili podmena ponyatij [Social partnership in Russia: specifics or substitution of concepts]. Sotsiologicheskiye issledovaniya [Sociological Research], 5: 56–66 (in Russian).

Certeau M. de (2013) Izobretenie povsednevnosti. Iskusstvo delat' [The invention of everyday life. The art of doing] Per. s fr. D. Kalugina, N. Movninoj. St. Petersburg: Evropejskii universitet v Sankt-Peterburge Publ. (in Russian).

Chilipenok Yu.Yu. (2013) Vzaimnye ozhidaniya osnovnyh sub"ektov rynka truda sovremennoj Rossii [Mutual expectations of the main subjects of the labor market of modern Russia]. In: Yadov V.A. (ed.) Trudovye otnosheniya: sostoyanie i tendencii razvitiya v Rossii [Labor relations: state and development trends in Russia]. Samara: Samarskij universitet Publ.: 213–222 (in Russian).

Goffman I. (2000) Predstavlenie sebya drugim v povsednevnoj zhizni [The Presentation of Self in Everyday Life]. Moscow: Kanon-Press Publ. (in Russian).

Higgs P., Scambler G. (eds.) (2005) Modernity, Medicine and Health: Medical Sociology towards 2000. London: Taylor and Frances.

Karaeva O.S. (2016) Reforma zdravoohraneniya v ocenkah vrachej i pacientov. Sociologicheskij analiz institucional'nyh izmenenij 2012–2016 gg. [Health care reform in the assessments of doctors and patients. Sociological analysis of institutional changes in 2012-2016]. Vestnik obshchestvennogo mneniya [Bulletin of public opinion], 3–4 (122): 93–108 (in Russian).

Klement K.M. (2004) Formal'nye i neformal'nye pravila: kakov optimum? [Formal and informal rules: what is the optimum?]. In: Stanovlenie trudovyh otnoshenij v postsovetskoj Rossii [Formation of labor relations in post-Soviet Russia]. Ed. by V.A. Yadov. Moscow: Akademicheskij proekt Publ.: 135–192 (in Russian).

Luhmann N. (2001) Vlast’ [Trust and Power]. Moscow: Praksis Publ. (in Russian).

Polterovich V.M. (1999) Institucional'nye lovushki i ehkonomicheskie reform [Institutional traps and economic reforms]. Ekonomika i matematicheskie metody [Economics and mathematical methods], 35(2): 3–20 (in Russian).

Semenova A.V., Korsunskaya M.V. (2010) Kontent-analiz SMI: problemy i opyt primeneniya [Media content analysis: problems and application experience]. Moscow: Institut sociologii RAN Publ. (in Russian).

Sheyman I.M., Shevskiy V.I. (2014) Pochemu v Rossii ne khvataet vrachej? [Why are there not enough doctors in Russia?] Ekonomicheskaya politika [Economic policy], 3: 157–177 (in Russian).

Shilova L.S. (2008) Reformy zdravoohraneniya kak istochnik novyh riskov dlya zdorov'ya [Health reforms as a source of new health risks]. Ed by A.V. Mozgovaya. Sociologicheskie koordinaty riska [Sociological coordinates of risk]. Moscow: IS RAN Publ.: 68–88 (in Russian).

Shсhepin V. O. (2013) Obespechennost' naseleniya Rossijskoj Federacii osnovnym kadrovym resursom gosudarstvennoj sistemy zdravoohraneniya [Provision of the population of the Russian Federation with the main human resource of the state health care system]. Problemy socialnoy gigieny, zdravookhraneniya i istorii meditsiny [Problems of social hygiene, health care and history of medicine], 6: 24–28 (in Russian).

Tarasenko E.A., Horeva O.B. (2016) Ekonomicheskoe stimulirovanie dlya ustraneniya deficita medicinskih kadrov v sel'skih territoriyah [Economic incentives to eliminate the shortage of medical personnel in rural areas]. Voprosy gosudarstvennogo i municipal'nogo upravleniya [Issues of state and municipal administration], 4: 117–142 (in Russian).

Temnitskiy A.L. (2005) Predposylki vyrashchivaniya institutov partnerstva v sfere trudovyh otnoshenij: konceptual'nye modeli i ehmpiricheskaya proverka [Prerequisites for the development of partnership institutions in the field of labor relations: conceptual models and empirical testing]. In: Yasin E.G. (ed.). Book. 2. Modernizaciya ekonomiki i vyrashchivanie institutov v 2-h knigah [Modernizing the economy and growing institutions in 2 books]. Moscow: GU VSHEH Publ. [https://mgimo.ru/files/34059/34059.pdf ] (accessed: 23.01.2019) (in Russian).

Tikhonov A.V. et al. (2017) Rossiya: reformirovanie vlastno-upravlencheskoj vertikali v kontekste problem sociokul'turnoj modernizacii regionov [Russia: reforming the power-management vertical in the context of socio-cultural modernization of regions]. Moscow: FNISC RAN Publ (in Russian).

Tukumtsev B.G. (2013) Sostoyanie trudovyh otnoshenij na predpriyatiyah rossijskoj promyshlennosti [State of labor relations at the enterprises of the Russian industry]. In: Yadov V.A. (ed.) Trudovye otnosheniya: sostoyanie i tendencii razvitiya v Rossii [Labor relations: state and development trends in Russia]. Samara: Samarskij universitet Publ.: 7–40 (in Russian).

Yanitskiy O.N. (2003) Sociologiya riska: klyuchevye idei [Sociology of risk: key ideas]. Mir Rossii [Universe of Russia], 3: 3–35 (in Russian).

Zaslavskaya T.I. (1999) Social'naya traektoriya reformiruemoj Rossii: issledovaniya Novosibirskoj ehkonomiko-sociologicheskoj shkoly [The social trajectory of a reformed Russia: studies of the Novosibirsk school of Economics and sociology].Novosibirsk: Nauka Publ. (in Russian).

Zulin YA.V., Bortsov V.A. (2013) Organizaciya ambulatorno-poliklinicheskoj pomoshchi v Evrope [Organization of outpatient care in Europe]. Medicinskie novosti [Medical news], 7(226): 77–80 [https://cyberleninka.ru/article/n/organizatsiya-ambulatorno-polikliniche... ] (accessed 01.02.2019) (in Russian).

Опубликован
2019-10-20
Как цитировать
Бояркина, С. (2019). Реформа российского здравоохранения 2011–2016 гг. в оценках представителей врачебного сообщества: стратегии, тактики, риски. ЖУРНАЛ СОЦИОЛОГИИ И СОЦИАЛЬНОЙ АНТРОПОЛОГИИ, 22(3), 39-56. https://doi.org/10.31119/jssa.2019.22.3.2