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).

Abstract

This article is devoted to analysis of social processes accompanying to modernization and optimization of treatment facilities. Political and economic changes make direct and indirect influences that transform organizational environment and derivate the risks for health. The aim of this paper is to examine political strategies, administrational strategies and tactics and health care workers’ tactics that are used to adapt to new organizational environment. The main issue is political and organizational conditions producing organizational and institutional risks in the treatment facilities located in Russian territory. Content analysis was used to research materials that were published from 2011 till 2016 at the Internet portal for the health care workers (HCW). There were analyzed news events devoted to law base and linked with labor condition changes in the health care system. Health care workers’ comments to these events that reflected labor conditions problems in the regional treatment facilities located in the Russian territory were the subject of our research. Governmental reform politics being produced and then introduced to treatment facilities functioning are followed with conflict of interests, tension in organizational environment and deterioration of HCW’s labor conditions. The problems which are the most significant for HCW having been produced by health care system reform are the following: bureaucracy in labor; physical and psychological overloads that are inadequate to salaries; massive reductions in personnel and chronic understaffing; professional burnout and stress; gaps in physical security; lack of material, technical and pharmaceutical resources. There are two ways for health care workers to be adapted to the transformations: changing the environment or changing their own behavior. In first case they act according the norms but if they don’t agree internally, they do it formally, not acting but simulating the act. In second case they try to change the environment and protest to new order. Both of these tactics being combined with political and administrative pressure to organizational environment can derivate the risks of modernization for health.