Article Information

HEALTH CARE REFORM IN RUSSIA (2011–2016) IN THE PHYSICIANS’ ASSESSMENTS: STRATEGIES, TACTICS, RISKS

Saniya Boyarkina (s.boyarkina@socinst.ru)

The Sociological Institute of the RAS — Branch of the Federal Center of Theoretical and Applied Sociology of the Russian Academy of Sciences, Saint Petersburg, Russia

Citation: Boyarkina S. Problemy reformy rossiyskogo zdravookhraneniya 2011–2016 gg. v otsenkakh predstaviteley vrachebnogo soobshchestva: strategii, taktiki, riski [Health Care Reform in Russia (2011–2016) in the Physicians’ Assessments: Strategies, Tactics, Risks]. Zhurnal sotsiologii i sotsialnoy antropologii [The Journal of Sociology and Social Anthropology], 22(3): 39–56 (in Russian). https://doi.org/10.31119/jssa.2019.22.3.2 

Abstract. This article analyses social processes associated with the modernization of health care and the optimization of health care facilities that cause not only manifest but also latent consequences leading to a change in the organizational environment and becoming a source of health risks. The author used a content analysis of the materials at the Internet portal for the health care workers published from 2011 to 2016. The author analyzed the events of the news feed on changes in the regulatory framework in the field of healthcare and working conditions in health facilities, and the comments of health workers containing information on the problems that arise in regional health facilities during the reform. The results of the study show that the consequences of the reform, such as the bureaucratization of medical activities, staff shortages, including those caused by excessive dismissals, and overloads not corresponding to wages, have become most relevant for medical workers. Being a translator and interpreter of norms, the administration of health care facilities has the ability to compensate or enhance these effects, becoming a factor that determines the conditions of the organizational environment and the behavior of medical workers. In general, the results suggest that the development of standards at the highest levels of government and their implementation at regional health care facilities are accompanied by tension in the organizational environment, worsening working conditions of medical personnel, and contribute to the formation of sources of institutionally and organizationally produced risks.

Keywords: health care reform, power strategies, formal norms, administrators’ and physicians’ tactics, risk production. 

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