Özet:

Abstract Significance. The economic changes observed in recent decades in the Russian Federation have significantly affected state support for the social sphere and the health care system. In the context of overcoming the economic crisis, the state is making every possible effort to preserve the system’s stability of providing medical and social assistance to elderly and senile people. At the same time, society is witnessing the steady development of private (commercial) healthcare. A relatively significant proportion of people, including those older than working age, are ready and able to receive medical services in these institutions. At the same time, ensuring the quality of medical care should remain unchanged. Purpose: to assess the current state of geriatric care in medical institutions of various ownership forms and suggest ways to improve it. Material and methods. For the study randomly selected 1829 middle-aged adults (ages 40 to 59 years, mean age of 47.2+2.3 years, men – 882 people, women – 947 pers.), and 2362 people elderly (aged 60 to 74 years, mean age of 68.6+2.2 years, men – 997 people, women – 1365 people). The observation period was four years. This study was multi-stage; at each stage, different statistical analysis methods were used, such as: analytical, monographic, comparative analysis, sociological (using a test survey), mathematical analysis. Results. There were no significant differences between public and private companies’ indirect relationships (p>0.05). When studying the nature of relationships in the hierarchy, it was revealed that in public institutions, vertical ties were rated by experts at 7.0+0.2 points (strong), in private ones 9.0+0.3 (very strong); horizontal ties in public institutions were rated by experts at 7.6+0.1 points (strong), in private, 7.8+0.2 points (strong). Vertical connections were significantly stronger in private institutions than in public ones (p<0.05). The nature of the horizontal links has no significant differences (p>0.05). Conclusion. The ways of developing and integrating public and private health care institutions to provide medical care to the elderly and senile age consist of forming a unified system of medical and rehabilitation measures.

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