TRENDS IN THE RUSSIAN FEDERATION ENDOCRINOLOGY WORKFORCE
Introduction. In connection with the growing prevalence of diabetes mellitus and obesity, solving the problems of staffing with endocrinologists is especially important. More than 80% of patients begin and end treatment on an outpatient basis, therefore, a special role is assigned to endocrinologists who provide primary specialized medical care in a polyclinic. Purpose. To assess the dynamics of staffing with endocrinologists who provide medical care to the adult population in comparison with the dynamics of staffing with doctors of all specialties in 2014-2018 in the RF. Materials and methods. The research used methods: analytical, statistical, comparative analysis and content analysis. The official statistical data of Rosstat, the Ministry of Health of the Russian Federation and the Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation as a whole for the Russian Federation and the constituent entity of the Russian Federation, the analysis of the data of the reporting forms of the federal statistical observation (FSO) № 30 for the period 2014-2018 was carried out. Results. An increase in the number and provision of endocrinologists and doctors of all specialties in the period from 2014 to 2018 was revealed. At the same time, the staffing of full-time positions of endocrinologists and doctors of all specialties has been steadily decreasing throughout the entire study period, and this indicator is consistently lower among endocrinologists who provide medical care on an outpatient basis. The subjects of the Russian Federation with high and low availability of both doctors in general and endocrinologists in particular have been identified. In the structure of doctors of all specialties, according to the staffing table, 56% work on an outpatient basis, and in the structure of endocrinologists, 77-78% work in primary care. Discussion. Assessment of the dynamics of staffing by endocrinologists and doctors of all specialties has a unidirectional trend, which is confirmed by the studies of other authors. At the same time, against the background of a gradual increase in the number of endocrinologists and their provision per 10 thousand of the population, a decrease in the number of endocrinologists was established, especially in outpatient settings. This trend is not consistent with the proportion of patients receiving outpatient and inpatient care. To optimize the situation, it is necessary to increase the attractiveness of the work of doctors in the primary link of the state healthcare system, to attract personnel from private medical clinics, and to train endocrinologists in residency. Conclusions. Thus, there is an increase in the provision of endocrinologists, which generally coincides with the trends in the provision of doctors of all specialties. Among the main problems, one can single out a steady decline in the staffing of full-time positions with endocrinologists and doctors of all specialties, both in the organization as a whole and separately in outpatient and inpatient settings, and this indicator is lower in polyclinics. Nevertheless, the number of endocrinologists and the availability of endocrinologists per 10 thousand population is gradually growing. These trends indicate the possibility of increasing the staffing level of endocrinologists by attracting personnel from the private sector, as well as the need to increase the attractiveness of work in state polyclinics. To optimize the staffing situation, it is necessary to bring the staffing table of medical organizations in line with the real needs of the population in medical care in the "endocrinology" profile.