МОДЕЛИ И МЕТОДЫ ПРОГНОЗИРОВАНИЯ РЕСУРСОВ ЗДРАВООХРАНЕНИЯ В ГОРОДСКИХ АГЛОМЕРАЦИЯХ: ЛИТЕРАТУРНЫЙ ОБЗОР

Актуальность. Рост населения в городских агломерациях создаёт количественно измеримый разрыв между спросом на медицинскую помощь и обеспеченностью кадровыми, лекарственными, финансовыми и материально-техническими ресурсами. Алматинская агломерация концентрирует около 3,5 миллиона жителей с прогнозируемым ростом до 4,5 миллиона человек к 2030 году. По данным Министерства здравоохранения Республики Казахстан, в 2023 году дефицит врачей составил 4 864 ставки, а коэффициент совместительства достиг 1,4, что отражает системную перегрузку кадров.

Цель. Анализ современных моделей прогнозирования потребности в ресурсах здравоохранения в городских агломерациях с фокусом на инструментах машинного обучения, их оценки применимости к условиям Алматинской агломерации.

Материал и методы: Поиск литературы был проведен в базах данных PubMed, Scopus, Web of Science Core Collection, WHO IRIS за период с января 2010 года по март 2026 года. В обзор включались оригинальные исследования, систематические обзоры и методологические отчёты ВОЗ/ОЭСР, содержащие количественные прогностические модели с оценкой точности (MAE, RMSE, MAPE, AUROC, R²) на уровне городских агломераций или регионов с уровнем урбанизации ≥ 50 %. Из 1 286 идентифицированных записей в обзор включены 57 публикаций.

Результаты. Статистические модели были наиболее распространены (40,4 %), затем методы машинного обучения с учителем (34,0 %), гибридные модели (17,0 %), методы машинного обучения без учителя - лишь в 4 публикациях (8,5 %). Только 3 модели (6,4 %) валидированы на данных Казахстана и охватывают исключительно категорию кадровых ресурсов. Ни одна модель не охватывает одновременно все четыре категории ресурсов.

Выводы. Методологические данные обзора обосновывают разработку интегрированной модели прогнозирования на основе машинного обучения без учителя для Алматинской агломерации с охватом не менее трёх категорий ресурсов и горизонтом прогноза 5-10 лет в соответствии с национальными плановыми документами.

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