The Russian Science Foundation will support a research project headed by Ekaterina Borozdina, Candidate of Sciences in Sociology, Dean of the EUSP Department of Sociology and Philosophy.
The project titled Patient-centered care in Russian healthcare: organizational challenges and professionals' opportunities will be implemented at EUSP between July 2019 and June 2022. It was among the winners of a contest for grants provided by a Presidential program for research projects carried out by leading scholars, including young researchers.
Information about the project is available on the RSF website:
A modern view on health care suggests that not only medical component is important for the modernization of this industry (implementation of principles of evidence-based medicine, creation and dissemination of new medical technologies), but also closer attention to the patients' perspective - their comfort, needs, satisfaction with the quality of services provided. Such an approach is necessary in order to rationally use the resources of the industry, to make it adequate to the current needs of the population and local (including regional) features. The goal of the proposed project is to explore the perspective and role of the patient in conditions of transforming healthcare system based on empirical data. The stated problem is fundamental and one of the central for social studies of medicine. Furthermore, in the context of Russian health care system it has particular relevance. This relevance is defined by two interrelated aspects - applied and theoretical. The applied aspect is connected with the contradiction between the attempts of the state to improve quality and availability of medical care through reforms, on the one hand, and the decline in citizens' trust in medicine, on the other. According to “VCIOM”, in 2015 more than half of respondents (55%) spoke of trust in doctors, and in 2017 only 36% did so (https://wciom.ru/index.php?id=236&uid=3590). Creating a patient-oriented medicine is one of the main strategic aims of the National Healthcare project. However, the implementation of this task is impossible without examining the reasons for the observed mistrust of the population in the health care system and without understanding what patients themselves expect from medical care. The relevance of the project for the development of social theory is determined by the fact that it brings the data on the role and perspective of the patient in the context of post-Soviet medical reforms into scientific circulation. The starting point for this study is the hypothesis that in the context of health care reforms there is a transformation of the social role and expectations of the patient, which in turn creates both new challenges and new opportunities for improving medical care. The methodological novelty of the project is related to the complex and interdisciplinary approach to the issue. Existing studies of the doctor-patient communication usually gravitate to one of the poles, depending on its disciplinary affiliation - to the social sciences or to the field of medicine. The contribution of this project will be connected with bridging this gap and developing an interdisciplinary methodological language through which physicians and sociologists can jointly study and analyze questions of patients’ satisfaction with the quality of medical care, trust in medicine and expectations from it. Another aspect of the complexity of the proposed project is a combination of qualitative and quantitative methodology of sociological research. On the one hand, such a variety of research tools will allow summarizing the main trends in the doctor-patient relationships, and on the other hand, to comprehend these trends from the perspective of insiders - doctors and patients - immersed in the process of institutional changes by using interviews and ethnographic observation data.
On the one hand, significance of the project is determined by structural challenges which exist in the area of health care development and improvement of its efficiency, and on the other hand, by analytical contribution to the current scientific discussion on the role of patients in the process of institutional changes. The expected results of this project are (1) articulation of the main problems that arise in doctor-patient communication and lead to decrease in patients' satisfaction with the quality of medical services (2) identification of institutional conditions that cause these problems, (3) identification of innovative organizational and communication solutions which contribute to the incorporation and implementation of the principle of patient-orientated care into the work of medical institutions. The planned results will be presented to the scientific community in the following formats: 1) by the end of the project members of the research team will publish at least 9 scientific articles in leading peer-reviewed journals; 2) based on the results of the project, it is planned to prepare a thematic issue of a journal included in Scopus or WoS, with the articles of the project participants and other scientists dealing with similar problems, 3) project results will be presented in presentations at scientific conferences, and at a specially organized interdisciplinary international scientific seminar.