Quality and access to health care for population (regional aspect)

The article actualizes the problem of assessing the quality and availability of medical care in Russian health care. The aim of the research is to analyze the availability and quality of medical care in the sub-regional cross-section of the Vologda Oblast, identifying the differences between the territories, organizations of commercial and public health sectors. The work is based both on statistical reporting data (the indicator of availability of medical care is the accessibility of doctors to the population, the quality of medical care - the level of professionalization and qualification of doctors), and on subjective assessments of residents obtained in surveys (quality and availability indices of medical care are calculated based on the survey data). The scientifi c novelty ofthe research consists in approbation of original methodology of binary analysis of two key parameters of medical care - availability and quality, based on calculated indices on materials of the COVID-19 pandemic period. As an alternative to the common in the Russian and foreign literature and management practices of discrete analysis of availability and quality of medical care or their interpretation as synonymous categories, the author approves the approach that involves their joint assessment within a two-dimensional measurement space, and shows its analytical advantages. The analysis, carried out within the framework of this approach, allowed identifying variants of conjugation and dichotomy between the parameters of availability of medical care quality in comparative territorial and structural contexts, in the subjective assessments of respondents. As a result of the research, we have been able to establish that organizations of the commercial sector receive higher estimates of the availability and quality of medical care and services than state medical institutions, which indicates both the formation of a new culture of medical activity and the emerging risks for the residents of the region. The practical value of the obtained results consists in approbation of the methodology of assessment and analysis of availability and quality of medical care as opposing categories in the territorial comparison, which will allow planning the development of health care based on the opinions of the residents of the territories.