THE DYNAMICS OF NURSE’S PERSONNEL STRUCTURE IN REPUBLIC KAZAKHSTAN FOR THE PERIOD of 1980-2004

Z.K.Buribaeva

The Kazakh national medical University named S.D.Asfendijarov

Almaty, Republic Kazakhstan

For definition of dynamics of personnel structure of nurses by us the analysis of the official statistical data for the period of 1980-2005 has been carried out. At studying changes of personnel structure of nurses for the 25-years period we had been used the historical approach concluding in definition of interrelation of parameters of a condition of the staff of nurse’s medical personnel and some medical-demographic parameters.

At the analysis of dynamics of number of doctors and nurses its linear dependence on change of republican population is established. The worst situation with personnel’s security was observed during 1995-2000. These years the maximum level of the loss of an aggregate number of the population (basically is established, due to reduction of number of urban population) for the various reasons (social and economic crisis, falling of a standard of living, unemployment, activization of process of an external migration, growth of diseases, increase of infantile and parent death rate, etc.).

During the same period there was a significant outflow of the staff from system of public health services: in 2000 in comparison with 1995 the number of doctors was reduced to 18,6%, nurses - almost on third (on 35,9%). Especially big outflow nurses was observed from rural public health services - 35,9% in comparison with 25,8%-s' loss from city public health services.

Positive dynamics of a gain of analyzed parameters with 2000 is interconnected, first of all, to improvement of a social and economic condition of the country. Thus the gain of doctors’s number outstrips a similar parameter of nurses (10,3% against 8,1%). The parameter of a gain of nurses’s security in city and rural public health services corresponds to changes of growth of parameters of number city and countrymen.

Special interest represents the comparative analysis of parameters in dynamics of 2004-1980 and 2004-1990. It is necessary to note, that the most indicative is the comparative analysis of the data for 1990 which is proved it is considered experts «the best peak of development of the Soviet system of public health services». So, in comparison with 1990 the loss of doctors in 2004 has made 20,6%, twice more this parameter at nurses. Thus, despite of small growth of number of agricultural population security of rural public health services nurses has the significant return tendency: loss nurses in rural medicine organizations has made 41,3%.

At the comparative analysis of medical-demographic parameters linear dependence with a parameter security of medical specialists also is established: direct dependence of parameters of birth rate, a natural increase and infantile death rate and inverse relationship with a parameter of death rate.

Studying changes of a gain of parameters of the common diseases of republican population and security medical specialists for the period of 1990-2004 has revealed the following tendencies:

- In 1980-1989 on a background of gradual growth of a parameter of the common diseasing of the population the parameter of security medical specialists also increased;

- In 1990-1995 on a background of sharp increase of parameters of diseasing (almost in 2 times) there was a reduction of number of doctors and nurses (on 11,4% and 18,6%);

- In 1995-2000 insignificant reduction of the common diseasing (on 1,1%) was accompanied by significant outflow of the staff from system of public health services (on 9,9% of doctors and 28,8% nurses), thus small reduction of a level of the common diseasing speaks reduction these years volumes of prophylactic medical examination that has led to sharp falling of a parameter of pathology’s revealing while the separate profound researches had been established high figures and a sharp gain of true diseasing;

- In 2000-2004 positive rates of a gain of parameters of diseasing and number of medical specialists are approximately similar to the period of 1980-1989;

- The comparative analysis modern given (2004) be relative «a critical point» in a history of public health services (1990) has revealed a significant gain of diseasing (on 147,7%), is especial in group of teenagers (on 224,4%), given birth during the period in 1988-1990, this fact it is possible to consider deterioration of rendered medical aid which demands carrying out of the additional profound research as «the indirect certificate»;

- On a background of growth of diseasing of Kazakhstan population the aggregate number of doctors and nurses for the period of 1990-2004 has decreased (on 11,9% and 37,4% accordingly).

Dynamics of parameters of security of the population medical specialists, hospital bed-places, scheduled capacity of ambulance medicine organizations has the same tendencies, as the above described parameters.

At studying changes of parameters of common number medicine organizations in republic and quantities of the medical specialists occupied in them the tendency of reduction of number medicine organizations is established during 1991-2000 which was accordingly accompanied also by reduction in number of working specislists and which is one of the reasons of outflow of the staff from public health services. If in 1980 the average of medical staff (and nurses) in one medicine organization (ambulance medicine organizations and hospitals) made doctors 48,7, in 1985 and 1990 this parameter continued to grow (51,9 and 54,6) 2000, and in 1996 and has considerably decreased (46,0 and 33,0) and now tends to increase (38,1 in 2004).

At the analysis of structure of nurses’s personnel structure in dynamics for 1980-2004 it is established, that (the number of the medical assistants occupied in public health services almost was twice reduced to 57,4%), on third - midwifes (on 37,6%) and dental technics (on 35,2%), on a quarter - assistants to health officers / assistants to epidemiologists (on 25,8%), disinfectors (number has fallen to 13,5%) and nurses (on 8,9%); (the number of laboratorians has increased by 24,1%).

Dynamics of factor of a parity of doctors and nurses in Kazakhstan for the analyzed period has shown its gradual falling with 3,1 in 1980 up to 2,1 in 2004 that testifies to growth of working loading on doctors and, accordingly, deterioration of conditions both medical, and sisterly work.

Thus, at the analysis of dynamics of number of doctors and nurses its linear dependence on change of Kazakhstan population is established, thus the worst situation was observed during 1995-2000, during this period there was a significant outflow of the staff from system of public health services.

Positive changes of a gain of analyzed parameters since 2000 is established, and rates of a gain of parameters of diseasing and number of medical specialists are approximately similar to the period of 1980-1989.

The comparative analysis of the data for 2004 and is considered experts «the best peak of development of the Soviet system of public health services» 1990 which is proved, has revealed, that the loss of doctors has made 20,6%, twice more this parameter at nurses. Linear dependence of parameters of security by medical experts and parameters of diseasing, birth rate, a natural increase and infantile death rate (direct dependence) and inverse relationship with a parameter of death rate is established.

The tendency of reduction of number medicine organizations is revealed during 1991-2000 which was accordingly accompanied also by decrease in number of working experts and which is one of the reasons of outflow of the staff from public health services.

The structure of nurses’s personnel in dynamics for 1980-2004 it is established.

Gradual reduction of factor of a parity of doctors and nurses in Kazakhstan for the analyzed period testifies to growth of working loading on doctors and, accordingly, deterioration of conditions both medical, and nursing work.