The professional structure of Soviet medical care: The relationship between personal characteristics, medical education, and occupational setting for Estonian physicians

Objectives. Using the Estonian example, this study provides data to describe the ways in which personal, educational, and occupational factors interacted to determine the professional structure of the Soviet health care system. Methods. The study analyzes data gathered from a survey of 20% of the physicians in Estonia. It measures the frequencies of pertinent personal and occupational factors, and uses multivariate analysis to explore relationships between these factors. Results. Most physicians in Estonia are women and work in urban settings. About half of the physicians work in hospitals, and one third work in large outpatient clinics called polyclinics. About one third work in primary care. Gender affects education, specialty, type of workplace, and administrative duties; nationality affects education and administrative duties. Conclusions. The Soviet system of health care derived its professional structure from a combination of personal and occupational factors. Those considering options for reform of the health care systems of the newly independent states that once constituted the Soviet Union should appreciate the nature of these structural forces.