New staffing and regulatory framework for health resort care

The article considers health resort care as an integral part of the public health protection system. The analysis of the dynamics of the network of health resort organizations and the number of those treated and vacationing in 2005—2022 is carried out (Table 1). The multidirectionality of the processes is shown: the number of sanatoriums gradually increased until 2021 and decreased in 2022, while the number of sanatoriums-prophylactics decreased throughout the entire period. The change in the number of places and contingents is visualized on a semi-logarithmic scale; a sharp drop in indicators in 2020 due to the COVID-19 pandemic is noted. The second part is devoted to the analysis of the evolution of the staffing and regulatory provision of health resort institutions. Historical orders of the USSR and Russian Ministry of Health (1954, 1956, 2012, 2016, 2025) are systematized and their characteristics are given. It is emphasized that the documents of the 1950s were in force for over half a century and provided for standards for the number of beds and differentiation by profiles, including the positions of radiologists, clinical laboratories and functional diagnostics. Order No. 279n (2016) for the first time defined the standard through the “place of placement”, which led to a sharp decrease in mid-level personnel and the absence of round-the-clock work. Errors are noted: lack of standards for the auxiliary service, fractional number of positions, discrepancy with the nomenclature. The new order No. 196n (2025) eliminated fractional rates, partially clarified the job titles, but did not correct the methodological shortcomings. It is concluded that it is necessary to revise the standards that ensure an adequate number of employees and the effective use of the medical resources of health resort organizations.