Ways to reduce health risks in remote areas of the Russian Federation by improving health and sanitary care

Healthcare in Russia is facing a serious challenge as the healthcare system needs improvement and any territorial differences in access to healthcare services should be eliminated. Use of a territorial approach to providing healthcare and sanitary services to the population requires solutions that should entail their availability, high quality and low costs. The aim of this study is to identify promising areas where provision of healthcare and sanitary services can be improved in remote areas of the Russian Federation. A prototype mobile consultation and diagnostic center Saint Panteleimon has been tested in the operation mode. The center is a train made of railway cars manufactured by the Tver Carriage Works JSC and equipped for providing therapeutic, surgical, ophthalmological and other healthcare services as well as for conducting instrumental research and laboratory tests. The train followed routes within the Far Eastern and Siberian Federal Districts using the Eastern-Siberian and Zabaikalskaya railways. The total length of the routes was 7065 kilometers; they go through 59 railways stations. It took 86 days (75 of them workdays) to travel these routes completely. Overall, 9493 diseases were diagnosed in 7263 people who visited the train. Each fourth disease was diagnosed in examined patients for the first time in their lives. Diseases of the circulatory system, endocrine diseases, diseases of the musculoskeletal system, diseases of the eye and adnexa prevailed among those diagnosed in people who applied for healthcare services. One hundred and sixty-two people out of the examined patients were sent to an in-patient hospital. The most common causes for hospital admission included diseases of the musculoskeletal system, neoplasms, diseases of the circulatory system and endocrine diseases. Functioning of railway mobile consultation and diagnostic centers will reduce risks of health losses among population living in remote areas due to available qualified healthcare and sanitary aid, result in longer life expectancy and help preserve active longevity.