

Ensuring primary health care accessibility for the population of hard-to-reach areas of the Russian Federation as an indicator of improving the comfort of living conditions
https://doi.org/10.35627/2219-5238/2025-33-5-7-16
Abstract
Introduction: Population health strongly depends on accessibility and timeliness of primary health care. It is common knowledge that access to health care services in the region of residence is related to the perceived comfort of living conditions, disease rates, and life expectancy in the population. Elimination of territorial disparities in access has been defined as a relevant area of development of the health care system for the population of remote areas.
Objective: To determine the main directions for improving primary health care for the population to increase the comfort of living conditions in hard-to-reach areas of the Russian Federation.
Materials and methods: We analyzed the results of providing health care services during the 86-day operation of the Saint Panteleimon mobile medical center, a railway train consisting of cars specially designed and built by the Tver Carriage Works and equipped for rendering medical services and performing instrumental and laboratory tests.
Results: The train traveled along the East Siberian and Transbaikal railways in the Far Eastern and Siberian Federal Districts and stopped at 59 railway stations. The length of the routes was over 7 thousand km.
Discussion: A total of 7,263 people applied for medical assistance, in whom 9,493 diseases were diagnosed during the examination; 25 % of the diseases were diagnosed for the first time in life. Cardiovascular, endocrine, musculoskeletal, and eye diseases prevailed; 2.2 % of those examined were referred to hospitals. Measures related to the operation of the railway consultative and diagnostic center help raise the healthcare system in hard-to-reach areas to a higher level.
Conclusion: Health services provided by mobile consultative and diagnostic centers will significantly reduce the risk of loss of health in the population, increase life expectancy, maintain active longevity, and have a positive impact on the quality of life and comfort of living conditions in the East Siberian and Far Eastern regions. The accumulated experience can be used in other remote, sparsely populated areas.
About the Authors
O. I. KopytenkovaRussian Federation
Olga I. Kopytenkova, MD, Prof., Dr. Sci. (Med.); Chief Researcher, Department of Public Health Analysis and Monitoring; Professor, Department of Technospheric and Environmental Safety
4, 2nd Sovetskaya Street, Saint Petersburg, 191036
9 Moskovsky Avenue, Saint Petersburg, 190031
Bldg 1, 1 Pakgauznoe Highway, Moscow, 125438
M. F. Vilk
Russian Federation
Mikhail F. Vilk, Corresponding Member of the Russian Academy of Sciences, Prof., Dr. Sci. (Med.); Director
Bldg 1, 1 Pakgauznoe Highway, Moscow, 125438
O. S. Sachkova
Russian Federation
Oksana S. Sachkova, Prof., Dr. Sci. (Tech.); Head of the Educational and Methodological Center
Bldg 1, 1 Pakgauznoe Highway, Moscow, 125438
E. A. Jidkova
Russian Federation
Elena A. Jidkova, Cand. Sci. (Med.), Head
Bldg 1, 52a Malaya Gruzinskaya Street, Moscow, 123557
Y. A. Novikova
Russian Federation
Yuliya A. Novikova, Cand. Sci. (Tech.), Leading Researcher, Head of the Department of Public Health Analysis and Monitoring
4, 2nd Sovetskaya Street, Saint Petersburg, 191036
References
1. Kalininskaya AA, Bayanova NA, Kizeev MV, Balzamova LA. Assessment of preventable health losses in the rural population. Menedzher Zdravookhraneniya. 2022;(3):30- 36. (In Russ.) doi: 10.21045/1811-0185-2022-3-30-36
2. Andreev EM, Shkolnikov VM. The relationship between mortality and economic development in Russia and its regions. Demograficheskoe Obozrenie. 2018;5(1):6-24. (In Russ.)
3. Zhukova AK, Silaev AM, Silaeva MV. Spatial analysis of life expectancy in Russian regions. Prostranstvennaya Ekonomika. 2016;(4):112-128. (In Russ.) doi: 10.14530/se.2016.4.112-128
4. Kossova TV. Growth factors of life expectancy in modern Russia. Voprosy Statistiki. 2020;27(5):76-86. (In Russ.) doi: 10.34023/2313-6383-2020-27-5-76-86
5. Fomin MV, Miriazov TR. Scenarios for development of the settlement systems of Siberia and Russian Far East until 2030. Narodonaselenie. 2021;24(3):105-122. (In Russ.) doi: 10.19181/population.2021.24.3.9
6. Protsenko OD, Glazov KN, Ermakova SE, Yurikova IG. Main aspects of social and economic development and life support system of the population of the Arctic territories of the Russian Federation. Ekonomika i Upravlenie. 2018;(9(155)):4-11. (In Russ.)
7. Sidorovskaya TV, Danilova SL. Evaluation of the satisfaction of residents of northern regions with quality of medical services. Korporativnoe Upravlenie i Innovatsionnoe Razvitie Ekonomiki Severa: Vestnik Nauchno-Issledovatel'skogo Tsentra Korporativnogo Prava, Upravleniya i Venchurnogo Investirovaniya Syktyvkarskogo Gosudarstvennogo Universiteta. 2019;(1):46- 53. (In Russ.) doi: 10.34130/2070-4992-2019-1-46-54
8. Shartova NV, Grishhenko MYu, Vatlina TV. Territorial accessibility of medical institutions for the residents of the north of Russia. Vestnik Moskovskogo Universiteta. Seriya 5. Geografiya. 2023;78(5):104-114. (In Russ.) doi: 10.55959/MSU0579-9414.5.78.5.10
9. Bekeshova EN. Problems in the organization of primary health care for the rural population at the current stage. Byulleten' Nauki i Praktiki. 2020;6(1):145-154. (In Russ.) doi: 10.33619/2414-2948/50/16
10. Plutnitsky AN, Ogneva EI, Nizamova ER, Roshchin DO. Modernization of primary health care in the Russian Federation. Aktual'nye Problemy Meditsiny i Biologii. 2022;(1):30-34. (In Russ.)
11. Konshina EE, Ogneva EYu, Savchenko NA. On the implementation of the program for the modernization of the primary level of the Russian healthcare system. Menedzhment Kachestva v Medicine. 2021;(1):4-7. (In Russ.)
12. Kuhn B, Kleij KS, Liersch S, Steinhäuser J, Amelung V. Which strategies might improve local primary healthcare in Germany? An explorative study from a local government point of view. BMC Fam Pract. 2017;18(1):105. doi: 10.1186/s12875-017-0696-z
13. Aksenova EI, Gorbatov SYu. [International Experience in Ensuring Accessibility of Medical Care in Remote and Hard-to-Reach Areas. Expert Review.] Moscow: Research Institute for Healthcare Organization and Medical Management Publ.; 2021. (In Russ.) Accessed April 25, 2025. https://niioz.ru/upload/iblock/abd/abdc5a05d0d8ec9c85b933b21f80ab1b.pdf
14. Kiryanov DA, Kamaltdinov MR, Tsinker MYu, Chigvintsev VM, Babina SV, Kuchukov AI. Cascade model for assessing and predicting health losses prevented through control and supervisory activities of Rospotrebnadzor. Zdorov'e Naseleniya i Sreda Obitaniya. 2023;31(12):27-36. (In Russ.) doi: 10.35627/2219-5238/2023-31-11-27-36
15. Tarasenkо ЕА, Russkikh SV, Smbatyan SM, Beneslavskaya OA. On the contents of the draft strategy for countering the risks of public health quality decline associated with social determinants of health. Zdorov'e Naseleniya i Sreda Obitaniya. 2024;32(9):42-48. (In Russ.) doi: 10.35627/2219-5238/2024-32-9-42-48
16. Vasilieva TP, Larionov AV, Russkikh SV, Zudin AB, Vasyunina AE, Rotov VM. Methodological approach to assessing the quality of public health. Zdorov'e Naseleniya i Sreda Obitaniya. 2023;31(11):15-22. (In Russ.) doi: 10.35627/2219-5238/2023-31-11-15-22
17. Kalininskaya AA, Bayanovа NA. Scientific substantiation of the assessment of the territorial availability of primary medical health care to the rural population. Kazanskiy Meditsinskiy Zhurnal. 2020;101(6):890-896. (In Russ.) doi: 10.17816/KMJ2020-890
18. Pikalova LV, Ananina OA, Lazarev AF, Odintsova IN, Zhuikova LD, Kudyakov LA. Features of the organization of anticancer measures in territories with low population density on the example of the Tomsk region. Rossiyskiy Onkologicheskiy Zhurnal. 2017;22(1):44-50. (In Russ.) doi: 10.18821/1028-9984-2017-22-1-44-50
19. Tayurskaya OV. Problems of labor market development in remote regions of the Russian Federation. Ekonomika i Predprinimatel'stvo. 2022;(12(149)):470-474. (In Russ.) doi: 10.34925/EIP.2022.149.12.092
20. Vilk MF, Kopytenkova OI, Sachkova OS, Zhidkova EA. Ways to reduce health risks in remote areas of the Russian Federation by improving health and sanitary care. Health Risk Analysis. 2025;(1):137–143. doi: 10.21668/health.risk/2025.1.13.eng
21. Kuznetsova OV, Russkikh SV, Tarasenko EA, et al. Assessment of the current level of digitalization in the process of training of medical personnel. Zdravookhranenie Rossiyskoy Federatsii. 2024;68(3):234-240. (In Russ.) doi: 10.47470/0044-197X-2024-68-3-234-240
22. Tarasenko EA, Russkikh SV, Vasilyeva TP, Makarova EV, Gorbacheva NA, Rotov VM. Social determinants of health as a methodological basis to develop of strategies on public health improvement: Foreign experience and lessons for Russia. Sotsial'nye Aspekty Zdorov'ya Naseleniya. 2024;70(2):3. (In Russ.) doi: 10.21045/2071-5021-2024-70-2-3
23. Volkova OA. The human health as resource of demographic development of the Eurasian economic community: The sociological aspect. Problemy Sotsial'noy Gigieny, Zdravookhraneniya i Istorii Meditsiny. 2025;33(1):5-10. (In Russ.) doi: 10.32687/0869-866X-2025-33-1-5-10
24. Ushakova OV, Efimova NV, Tarasov AYu, Katamanova EV. Assessment of loss of health of the population of an older age group. Gygiena i Sanitariya. 2020;99(10):1170-1176. (In Russ.) doi: 10.47470/0016-9900-2020-99-10-1170-1176.
Supplementary files
Review
For citations:
Kopytenkova O.I., Vilk M.F., Sachkova O.S., Jidkova E.A., Novikova Y.A. Ensuring primary health care accessibility for the population of hard-to-reach areas of the Russian Federation as an indicator of improving the comfort of living conditions. Public Health and Life Environment – PH&LE. 2025;33(5):7-16. (In Russ.) https://doi.org/10.35627/2219-5238/2025-33-5-7-16