The article on the example of the Irkutsk region reveals the features and problems of the organization of medical service of the population in the conditions of reforming the health care system. The attention is focused on the importance of the spatial factor and transport accessibility of district centers in relation to the territories of service and the regional center – as the main multifunctional, high-tech and science-intensive center of medical care. The author identifies favorable factors in the organization of the health care system: the high concentration of the population in the main resettlement zone, the high level of urbanization, the multi-level system of medical care developed in the Soviet era. An adverse impact of the whole group of factors is established: 1) remoteness and the peripheral position of the study region, 2) dispersed, mostly sparsely populated nature of population settlement in the peripheral zone of the region, 3) large number of rural settlements, 4) weak socio-economic potential of district health care centers; 5) significant transport remoteness of the majority of district and regional service centers, 6) reduction of a number of statistical indicators of health care, especially the provision of doctors. Calculations of the relative transport accessibility of medical service centers of regional and district level and the dynamics of morbidity indicators, characterized by the growth of chronic non-infectious diseases (cardiovascular, cancer, etc.), show the need for the formation of an additional multifunctional medical service center of the regional level, primarily for the vast peripheral region of the North oblast.

Zelenyuk Julia Mikhailovna, Candidate of Science (Geography), Associate Professor, Irkutsk State University 1, K. Marx st., Irkutsk, 664003, Russian Federation, tel.: (3952) 52-10-71, zelenyuk.jm@yandex.ru

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