Modelling the Variation of the Impact of Medical Personnel Availability on Mortality Rates: Cardiovascular Disease Case

. The study attempts to empirically assess the impact of socio-economic and demographic characteristics of areas on the influence of the level of cardiologist availability on mortality rates from circulatory system disease. This research question with regards to improving the accuracy of the estimates under consideration is important for the implementation of the approach proposed in the literature to determine the optimal volume of specialist medical personnel on the basis of the Samuelson equation, which determines its relevance. It is necessary to develop approaches for estimating the marginal utility function of hiring additional specialist medical personnel for further comparison with the corresponding marginal cost function. To solve the problems of endogeneity, we use the instrumental variable method with the author's approach to constructing sources of exogenous variation based on spatial matrices and the approach to clustering areas using the k-means method. According to the obtained results, a higher statistically significant impact of profile medical personnel was observed in the territories characterised by higher values of such indicators as the share of elderly people, the share of urban population, real income per capita, alcohol consumption, tobacco consumption, total marriage rate and a lower value of the poverty rate. The variation in the estimates of the impact of the level of availability of cardiologists on mortality rates from circulatory system diseases in the considered subgroups of the federal districts of the Russian Federation was also demonstrated. In particular, the highest value of the corresponding coefficient is observed in the Central Federal District, while in such Federal Districts as the Southern Federal District, the North Caucasian Federal District, the Far Eastern Federal District, and the Siberian Federal District its value is significantly lower than the average Russian level, which was also observed in such federal districts as the Northwestern Federal District, the Volga Federal District, and the Urals Federal District. The results obtained can significantly improve the targeting of management decisions in the healthcare sector in terms of improving the validity of the level of provision of specialist medical personnel in different territories, both in terms of determining its optimal level and in terms of comparing the return on hiring medical personnel of different profiles.