Medical rehabilitation after total hip and knee arthroplasty: logistics and resource provision

Aim: analysis of problems of logistics and resource provision of medical rehabilitation of patients after total hip and knee arthroplasty. Material and Methods. In the period of 2013-2018 for 24 Russian regions studied: statistic materials of Federal Ministry of Health (form № 14); territorial government guarantee programs. Results. It was developed an author's scheme of logistics and resource provision of medical rehabilitation, describing 4 of its possible trajectories, guaranteed governmental funding sources, and infrastructure capabilities. It was revealed the regional differentiation and the lack of stable dynamics in tariffs growth for in-patient stage of medical rehabilitation - an increase in the tariff was revealed only in 8% of the regions, in a day hospital - in 29% of the regions. Conclusion. The insufficient amount of financial resources within the framework of budgetary allocations and the basic program of compulsory medical insurance leads to limited access for patients to the trajectory of the completed cycle of medical rehabilitation after these surgical interventions. The current practice reduces the medical and social effectiveness of concerned high-tech medical care programs that in the long run creates a risk of socio-economic devaluation of the medical result achieved at the stage of resource demanding surgical treatment.