Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR最新文献

{"title":"Results of a pilot project of microbial therapy management at the children’s hospital","authors":"Anna V. Vlasova, Elena V. Smirnova, Nadezda N. Volkova, Liliya V. Dymnova, Andrey E. Angel, Yulia V. Romanova, Antonina A. Rakhalina, Anastasia A. Sharshakova, Valerii V. Gorev, Marina V. Zhuravleva","doi":"10.47470/0044-197x-2023-67-5-397-402","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-5-397-402","url":null,"abstract":"Introduction. In multidisciplinary pediatric hospitals in Russia, the prerequisite for the formation of principles of antimicrobial therapy management as a medical technology, implemented with the participation of a clinical pharmacologist became possible on the basis of updated clinical and pharmacological tools proposed by the World Health Organization (WHO) in 2019. 
 Purpose. The project goal is to show the possibilities of control of antimicrobial therapy, as a medical technology in multidisciplinary children’s hospitals to improve adherence to domestic clinical recommendations in the actual clinical practice of implementing antibiotic therapy management programs in children on the profile of «Pediatrics». 
 Material and methods. The pilot scheme was implemented from 2019 to 2021 on the basis of the Morozov Children’s Clinical Hospital by methods of WHO AWaRe and points estimation of prevalence of antibiotic use according to WHO tool checklist in dynamics. Regulatory documents of medical organization (MO) were formed, which ensured transition from traditional to new approaches within 3 years from 2019 to 2021 to maintain clinical practice of antibiotic use based on clinical guidelines. 
 Results. A comparative study of clinical antibiotic use in children “before” the project in 2019 and “after” in 2021 showed a 2.7-fold decrease in antibiotic use by absolute DDDs from 65.99 in 2019 to 24.34 in 2021. DDDs per 100 p/d. By WHO AWaRe method for absolute values of antibiotics in the “Tolerance” category, a 2-fold decrease in consumption and a 5-fold decrease in consumption for absolute values of antibiotics in the “Control” category: in 2019. — 41.13% (abs. 27.55 PDT per 100 p/d) and in 2021. — 60.1% (abs. 4.64 PDT per 100 p/d). Consumption of “Reserve” category antibiotics by absolute values has not changed.
 Limitations. This publication describes one medical institution in which this project was implemented, which somewhat reduces the value of the results obtained.
 Conclusion. As a result of the implementation of the principles of managing antimicrobial therapy, this pilot project was able to reduce the irrational use of antibiotics in the pediatric hospital.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":"25 14","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135874217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approaches to improve management of patients with multiple chronic non-communicable diseases (literature review)","authors":"Natalya N. Kamynina, Dmitry A. Andreev, Mariam D. Pakhuridze, Grigory G. Sizov","doi":"10.47470/0044-197x-2023-67-5-417-422","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-5-417-422","url":null,"abstract":"A large fraction of adult patients has two or more chronic diseases (multiple chronic diseases, MCD). There are often questions about the quality and availability of medical care for patients with MCD, which could drastically be improved using information technologies (IT). 
 The purpose of this work was to study medical care management for MCD patients abroad using IT. 
 This study was carried out by searching the Google system and PubMed. 
 MCD patients are characterized by a high heterogeneity. Effective processing of the flow of medical information (electronic patient registers, digital medical records, scientific knowledge, etc.) is usually feasible with the help of artificial intelligence technologies and supercomputers. To improve health care delivery to adult MCD patients there are described three dimensions for the IT development including 1) development the algorithms to support clinical decision making; 2) coordination of medical care delivery; and 3) attainment of patient self-management. 
 The presented results confirm the important role of IT in medical care. The number of scientific reports devoted to this issue is growing. The use of IT in medicine demonstrates the promise of the principles of automated analysis and the provision of additional information directly at the point of care delivery. This can improve medical processes and, to some extent, clinical outcomes, including indicators of patients’ quality of life.
 Conclusion. Additional studies based on data from real-life clinical settings are required to make 
 a comprehensive assessment of the areas of IT applicability.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":"25 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135874082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modern age-specific pattern of mortality from cardiovascular diseases and its Moscow-specific features","authors":"Victoria G. Semyonova, Andrey A. Grigorov, Aleksandr V. Zubko","doi":"10.47470/0044-197x-2023-67-5-444-452","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-5-444-452","url":null,"abstract":"Background. Mortality from acute cardio-vascular diseases (CVD) remain a global challenge. Age-specific profiles of chronic and acute CVD deaths remain topical: is there any principal difference between the two?
 The purpose of the study is to analyze age-specific profiles of acute and chronic CVD deaths in Russia and identify Moscow-specific features.
 Material and methods. The study analyzed Rosstat data on mortality from leading CVD in Russia and Moscow in 2019.
 Results. The internal structure of acute CVD is characterized by age-specific vectors, more pronounced in Russia. Myocardial infraction makes the highest contribution accounting for 27.9% and 26.1% in ages of 70–74 years. The share of other acute IHD is over 20% in males and 15% in females under 60, increasing with age. Mortality from stroke unsurprisingly increases with age with the maximum of about ⅔ over senile ages.
 Sudden cardiac deaths are rather high among the Russian youth, while in Moscow they remain minimum throughout all ages.
 Limitations. An analysis was made of data on mortality from major cardiovascular pathologies in Russia and Moscow only in 2019.
 Conclusion. Age-specific profile of chronic and acute CVD are characterized by similar patterns: increase in age-specific indicators with the maximum in senile ages.
 Age profile of the Moscow mortality is characterized by high mortality from unspecified cardiomyopathy, many-fold exceeding the Russian indicator.
 Acute cardiac deaths require a further analysis to identify nosological criteria to evaluate death rates.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":"25 17","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135874214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features of maladaptive forms and guilt types in medical workers over the post-COVID period","authors":"Olga B. Polyakova, Tatyana I. Bonkalo","doi":"10.47470/0044-197x-2023-67-5-430-435","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-5-430-435","url":null,"abstract":"Introduction. The performance of professional duties in stressful conditions leads to the emergence of low-adaptive forms of guilt in medical workers.
 Purpose of the study is to identify the features of low-adaptive forms and guilt types in medical workers 
 in the post-COVID period.
 Material and methods. Eight hundred sixteen selected medical workers with pronounced maladaptive forms and guilt types participated in the study using questionnaires for measuring maladaptive forms and guilt types.
 Results. Above average levels of guilt of comprehensive responsibility, survivor’s guilt, low-adaptive forms of guilt in general, moral norms were revealed. The average level of guilt in general, the guilt of self-hated, the guilt of separation, the guilt of the state, the guilt of the trait. There was established a high correlation between moral norms and the guilt of the survivor, the guilt of comprehensive responsibility and the general indicator of low-adaptive forms of guilt; noticeable connection: guilt of comprehensive responsibility and guilt-state, guilt-feature and general indicator of guilt; survivor’s guilt, guilt-feature and overall guilt score.
 Limitations. The results of the study cannot be extrapolated to the professional profiles of all medical workers, since forms and types of guilt may be associated with other symptoms of post-traumatic stress.
 Conclusion. The results of the study will allow healthcare managersorganizers to systematically monitor stressful working conditions in order to prevent and level them, as well as to implement the prevention of low-adaptive forms and types of guilt in medical workers to maintain and strengthen their professional health.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":"25 13","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135874218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of publication activity and priority subject areas of research in medicine in the Russian Federation","authors":"Elena I. Aksenova, Kirill Yu. Tarkhov","doi":"10.47470/0044-197x-2023-67-5-374-381","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-5-374-381","url":null,"abstract":"Introduction. Scientometric analysis is one of the progressive methods and key tools for quantitative and qualitative study of science, identification of priorities and trends of its development. \u0000The purpose of the study is a scientometric study of Russia’s report activity in the field of medicine and determination of the priority subject issues of research in this area. \u0000Material and methods. The study was conducted using SciVal, according to scientometric indicators characterizing the number of publications in various categories and their citation for a three-year period (2019–2021) for the Russian Federation with the reference values for the world. \u0000Results. The main scientometric indicators (in number and share) characterizing the dynamics in Russia’s publication activity in medical sciences in 2019–2021 are considered and analyzed. A comparative analysis of the TOP five subject areas for 4 scientometric indicators for the world and the Russian Federation is carried out. \u0000Limitations. The research materials are limited to the results of the data uploading as of a specific date, as well as the selected time period. \u0000Conclusion. In the field of medicine, Russia is characterized by a steady growth and positive trend in the majority of the selected scientometric indicators. The leading subject areas of the Russian research are general medicine, public health, surgery, oncology, cardiology, immunology and allergology, clinical neurology. The scientometric analysis fully confirms the subject areas of the Russian scientific medical research to fully correspond to both domestic priority areas of medical science development specified in various regulatory documents and the world trends.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":"25 16","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135874215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality from circulatory diseases as a reflection of demographic aging","authors":"Tamara P. Sabgayda, Galina N. Evdokushkina, Alla E. Ivanova","doi":"10.47470/0044-197x-2023-67-5-436-443","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-5-436-443","url":null,"abstract":"Introduction. Even a decade ago, an increase in mortality from circulatory diseases (CVD) in Russia until 2050 was predicted, in parallel with an increase in number of people older than working age. The forecast did not materialize.
 The purpose is to identify the relationship between the level and structure of mortality from CVD and the proportion of elderly people.
 Materials and methods. Official Rosstat data on mortality in Moscow and the Russian Federation for period 1975–2019 were used. There was made a comparison of age patterns of mortality from CVD at the beginning and end of the analysed period in the country and in the capital separately for men and women. For simplicity of calculations, the trend in the gain in mortality with increasing age was approximated by an exponential function in the Microsoft Excel Software.
 Results. Since 2003 to 2019 in the Russian Federation, mortality from CVD was found to decline among men and women by 2.0 and 2.2 times. In Moscow, with a 2.3- and 2.2-fold decrease in mortality from CVD. During this period losses fell as a result of premature death from CVD by 1.8 and 1.9 times in men and women, as well as in Moscow.
 Limitations. The quality of analysed data is limited by quality of coding of the causes of death in different regions and by accuracy of estimate of age structure of the population in period between population censuses.
 Conclusions. Demographic aging does not lead to an increase in the contribution of CVD to the mortality of the population. The decrease in mortality from CVD significantly contributes to the growth of life expectancy and is accompanied by an increase in the proportion of elderly people. Only during periods of increased mortality, the contribution of CVD to it is directly proportional to proportion of elderly people. Age structure of mortality from CVD indicates the need to strengthen measures to prevent mortality.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":"25 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135874084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of behavioural and biological risk factors for non-communicable diseases among the population of Moscow","authors":"Ignat V. Bogdan, Maxim D. Gornostalev, Andrey P. Khlynin, Daria P. Chistyakova, Elena I. Aksenova","doi":"10.47470/0044-197x-2023-67-5-423-429","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-5-423-429","url":null,"abstract":"Introduction. High mortality from non-communicable diseases (NCDs) in Russia and worldwide, as well as the need to assess effectiveness of the government initiatives aimed at preventing the NCD spread, substantiate monitoring of the dynamics in prevalence of the NCD main risk factors in the region.
 The purpose was to study the prevalence of risk factors in the Moscow residents over seventeen years.
 Material and methods. 805 Moscow residents over seventeen years participated in a telephone survey (2022). Mobile and landline phone numbers were selected using a random, systematic, stratified, dual-frame sampling method applied according to the main module of the STEPS questionnaire, with some questions from the expanded module.
 Results. The monitoring results allowed identifying prevalence of the NCD behavioural and biological risk factors among Muscovites associated with the use of nicotine-containing products, alcohol, vegetables/fruits, and salt consumption, adherence to physical activity, high blood pressure, high glucose and cholesterol levels, a history of cardiovascular diseases, cervical cancer screening, and the use of certain medications and alternative medicine. Specifically, 29% of those surveyed consumed tobacco products, 13% had excessive alcohol use in the past month, 14% were regular salt users, 53% did not consume enough fruits and vegetables, and 20% did not meet WHO standards for physical activity. Health care providers had ever told 44% of those surveyed that they had high blood pressure, 16% that they had high sugar, and 32% that they had high cholesterol level.
 Limitations. The study was conducted as a telephone survey, so we were unable to obtain physical/biochemical data or investigate the impact of visual presentation on respondents.
 Conclusion. The information obtained can make a contribution to the existing public health programs and can be useful as a basis for future strategies aimed at combating NCDs.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":"25 15","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135874216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chatbots is the modern reality of consulting in medicine","authors":"Elena I. Aksenova, Elena I. Medvedeva, Sergey V. Kroshilin","doi":"10.47470/0044-197x-2023-67-5-403-410","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-5-403-410","url":null,"abstract":"Introduction. Modern digital innovations and artificial intelligence technologies are being actively introduced in Medicine. Now chatbots are able to provide consulting services and make appointments for patients, make a diagnosis. Chatbots can significantly improve the efficiency and accuracy of symptom detection, assist in remote biomonitoring. 
 Goal. To study the possibilities of development and directions of implementation of chatbots based on artificial intelligence technologies in medicine and to assess the potential of their application. 
 Material and methods. The study is prospective, includes analysis of secondary information and conducting an expert interview on issues related to the development, application practice, and distribution of chatbots. 
 Results. The survey showed most experts already to see the need to introduce chatbots in Medicine. The main advantages are: getting an “instant” response and saving patients’ time. The disadvantages of using chatbots may be: “incorrect interpretation” of both user requests and interpretation by patients. Experts see risks in the “erroneous” diagnosis and in the “measure of responsibility”.
 Limitations of research. The research materials are limited by the results of an expert survey conducted in 2023 and the quantitative and qualitative characteristics of the respondents who met the requirements for experts. 
 Conclusions. Chatbots in the field of healthcare have already become a reality in consulting and providing the necessary medical information. Thanks to the development of information technologies, chatbots are able to process significant amounts of data received from patients, quickly and accurately find answers, provide information support, and establish a preliminary diagnosis. Such solutions can reduce the burden on medical professionals and increase patient satisfaction.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":"25 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135874083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prerequisites and practice of introducing integrated systems of medical care in England","authors":"Sergey S. Budarin","doi":"10.47470/0044-197x-2023-67-5-389-396","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-5-389-396","url":null,"abstract":"The introduction of new conceptual approaches to public health protection is a trend of public health reform in Russia and European countries. The success of the implementation of public health policy in Russia depends both on the development of their own ideas and their implementation, on the study and use of the experience of foreign countries. For example, in England in the last decade, as part of the reform of the public health system, the idea of creating integrated medical care systems (ICS) has been actively developing and the experience of its implementation is of practical interest for Russian healthcare. 
 Goal. To study the experience of England in implementing integrated medical care systems and analyze the possibility of using its individual elements in Russia. 
 Materials and methods. The study was conducted on the basis of a comprehensive study of open reporting data of the Department of Health and Social Security of England, the National Health Service and the National Audit Office of England (NAO), as well as scientific reports on integrated public health management systems. 
 Results. The development of integrated public health management systems being a trend in world practice, contributes to the improvement of public health indicators. The study of the experience of implementing ICS in England showed the presence of a number of risks during its implementation.
 Limitations. When conducting research, there were no restrictions that could influence the preparation of the article.
 Conclusions. Dissatisfaction with the level of management and financing of the healthcare system in England served as an impetus for the start of reforms that contribute to improving the management of medical care to the population, and the introduction of integrated medical care systems. The analysis of the NAO auditors revealed the main risks of the success of the ICS implementation. Studying the experience of implementing ICS is useful for use in the implementation of Russian national projects in the field of healthcare and demography.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":"25 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135874085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of COVID-19 on the number and structure of medical specialists in Moscow","authors":"Anna A. Karnafel, Anastasia M. Podchernina","doi":"10.47470/0044-197x-2023-67-5-382-388","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-5-382-388","url":null,"abstract":"Introduction. Despite the presence of positive trends in the provision of medical specialties, there are currently a number of personnel problems in both Russian and world health care. The experience of fighting against coronavirus has proved the importance of solving personnel problems in healthcare, strengthening medical personnel in particular.
 Purpose. To assess the impact of the coronavirus pandemic on the number and structure of medical personnel in Moscow; to predict the number of medical personnel for a short-term period.
 Material and methods. The methods of mathematical-statistical and empirical analyses are used. To analyze the composition of medical personnel, data from the forms of federal statistical observation No. 30 “Information about a medical institution” provided by medical institutions in Moscow for 2013–2022 were used. Changes in the structure were estimated using the Gatev coefficient, Salai and Ryabtsev indices. The quality of proposed one–factor model (t — time) for prediction is proven by Fisher’s F-test and Student’s t-test (95 CI%).
 Results. During the pandemic, there was an outflow and shortage of doctors of certain specialties, which led to a huge overload of the remaining staff. As a result, the proportion of specialists under the age of 36 increased by 17.4%, and the number of therapists increased by 13.6%. The provision of doctors to the population in Moscow has increased by almost 5% over five years. By the end of 2023, the number of doctors of all specialties is expected to increase by 1.6–2.9%.
 Limitations of the study. When studying the number and composition of medical personnel, data from 251 medical institution of Moscow during 2013–2022 was used which is a fairly informative sample.
 Conclusion. The analysis showed a significant impact of COVID-19 on both the number and structure of medical personnel. There is a tendency to increase the number of doctors, and the enlargement of medical personnel is expected by the end of 2023.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":"25 21","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135874211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}