Accessible health care as a factor of sustainable socio-economic development of territories

Sustainable development of territories is largely determined by the regions’ socio-economic stability including the level of accessibility and quality of health care. In this regard, the study of the scale of health care accessibility and the elaboration of its improvement directions in order to ensure sustainable development of territories is of particular relevance. The author notes a low level of medical service accessibility in the Russian Federation due to a number of negative trends in 2010-2018. They have manifested in the reduction of budget financing of the health care sector and the volume of free medical care, the increase of the workload on doctors. The article demonstrates a typology of the Russian regions on the medical care accessibility using multidimensional methods of statistical analysis. Moreover, the researcher shows that there is an insufficient level of beds provision in hospitals in most of the regions. The author concludes that there is a direct correlation between the accessibility of health care and the number of cases according to the primary diagnosis with the level of health care costs. Based on the potential demography indicator “lost years of potential life”, the paper estimates the potential damage in GRP production in the Vologda Oblast caused by the mortality of the working-age population. The research establishes that the total amount of economic damage due to labor losses varied in 2016-2018 in the range from 10 to 15% of the GRP volume. The author has studied the population’s own perception of the accessibility and quality of medical care. To increase the stability of territorial systems, the work proposes a number of management measures to prevent a decrease in the number of working-age population and increase the health care accessibility. In the future, it is possible to develop a comprehensive methodology for assessing the medical care accessibility (using statistical and sociological indicators), and to identify the degree of mutual influence of accessibility and the processes of the territories’ sustainable socio-economic development.