Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR最新文献

{"title":"Prevention of nosocomial diarrhea using autostrains of lactobacilli isolated from wastewater and from the intestinal biotope of patients","authors":"Marina F. Sukhina, Sergei M. Yudin, A. V. Zagaynova","doi":"10.47470/0044-197x-2023-67-4-306-312","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-4-306-312","url":null,"abstract":"Introduction. The work is devoted to evaluating the results of own studies on the possibility of using autostrains of lactobacilli isolated from wastewater and the intestinal biotope of patients, based on their antagonistic properties to prevent of nosocomial diarrhea associated with toxigenic Clostridioides difficile. There are presented results of studies on an animal model of antibiotic-associated diarrhea to determine the effectiveness of lactobacilli when eliminating toxigenic C. difficile. \u0000Materials and methods. Studies were conducted on the antagonistic activity of clinical cultures of lactobacilli isolated from wastewater and intestinal biotope of patients against toxigenic strains of C. difficile isolated from patients with nosocomial diarrhea. Preclinical tests of the efficacy of the selected highly antagonistically active strain of Lactobacillus paracasei CTR079 in vivo were carried out in an animal model of C. difficile-associated infection in mice of the C57BL line. \u0000Results. As a result of the studies, lactobacilli with high, medium, and without antagonistic activity were isolated. Antagonistically inactive strains were unable to inhibit the growth of C. difficile, unlike highly active strains. A strain of Lactobacillus paracasei CTR079 was selected to study the possibility of its use as a probiotic strain for the prevention and treatment of C. difficile associated infection in an in vivo experiment. Various changes in the intestinal epithelium as a result of the development of C. difficile-associated infection. \u0000Limitations of the study. As part of the study, all isolated strains of lactobacilli were identified and stored for the study of biological, genetic properties, and production of bacteriocins. \u0000Conclusion. As a result of the studies, the use of highly active strains of lactobacilli was established to be a promising direction for the prevention and treatment of nosocomial diarrhea, which will reduce the spread of C. difficile among patients and in the environment of medical institutions.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70834886","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":"Experience of assessing the level of management in medical institutions in Brazil","authors":"Beatriz Marcondes de Azevedo, Yakov A. Stoian, Lioudmila I. Baturina, Fred L.S. Campos","doi":"10.47470/0044-197x-2023-67-4-292-299","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-4-292-299","url":null,"abstract":"Modern management literature describes various approaches to measuring the effectiveness of managing organizational structures. As a result, many interpretations and definitions of efficiency, methods and measures for their measurement have appeared. \u0000Objective. This article is a description of the experience of Brazilian scientists from the Federal University of Santa Catarina (UFSC) in developing a technology for evaluating the performance of hospitals in Brazil \u0000Material and methods. There were applied DEA (Data Envelopment Analysis) method, multi-stage quantitative and qualitative analysis, which can be useful in Russia. \u0000Results. The result of the study was the development of specific positive scenarios for the enhancement of the managing structures of the hospitals participating in the study. The work is practice-oriented, in terms of quantitative indicators being clearly ranked. Russian colleagues participated in the study at the stage of discussion of the results. The conclusions reached by the working group of Brazilian and Russian researchers are also significant for Russian medical institutions. \u0000Research limitation. The materials are limited to the results of scientific research of the Federal University of Santa Catarina, Brazil, and represent a sufficient reference sample obtained in 2017–2019. \u0000Conclusion. The use of DEA is an effective instrument to reflect the operational efficiency of medical institutions. Based on the results of performance evaluations, hospital managers can monitor their actions, as well as compare their own management system with other participants in the healthcare market. As a powerful management tool, DEA allows evaluating and comparing the managing units in a medical institution, transforming the information into a single index, being used as a measure of relative global performance.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42497156","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":"Mechanisms of mandatory vaccination: problems and solutions","authors":"A. Basova, G. Komkova","doi":"10.47470/0044-197x-2023-67-4-320-328","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-4-320-328","url":null,"abstract":"The problems of introducing mandatory vaccination against various infections exist both in foreign countries and in Russia. The World is searching for optimal legal incentives for the activity of the population in the immunoprophylaxis of diseases to ensure public health and infectious safety of the population. \u0000The purpose of the study. To assess the implementation of mechanisms for the introduction of mandatory vaccination in foreign countries and Russia, to identify problems and ways to solve them. \u0000Materials and methods: Normative legal acts, scientific literature, court decisions. The study used dialectical and logical methods, which created the basis for a comprehensive study of the optimal mechanisms of vaccination. There was applied the system-structural method allowed investigating the problem of non-vaccination in its relationship with the constitutional guarantee of public health protection in the Russian Federation, the comparative legal method that allowed analyzing regulations in different countries of the world. \u0000Results. There are analyzed modern legal mechanisms of mandatory vaccination in foreign countries and in Russia. The existing threats of non-vaccination for public health are identified. The main forms of legal responsibility for non-compliance with vaccination requirements by Russian citizens are established. \u0000Limitations. The implementation of the vaccination process in the Russian Federation is carried out on the basis of federal legislation, which ensures the legality, unity of the requirements of its management throughout the country and reliability of the study. \u0000Conclusion. The preservation of public health is a constitutional duty of public authorities, therefore, in the conditions of epidemics and pandemics. It is possible to establish mandatory vaccination and restrictions on the rights of citizens, which must be justified and temporary.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42557478","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":"Assessment of socio-economic losses from premature mortality of the population of the Republic of Bashkortostan (for 2002–2020)","authors":"Valery P. Chashchin, R. A. Askarov, Z. F. Askarova, I. A. Lakman, Marina V. Frants","doi":"10.47470/0044-197x-2023-67-4-344-351","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-4-344-351","url":null,"abstract":"The purpose of the study is to assess the socio–economic losses caused by premature mortality of the population of the Republic of Bashkortostan from the main classes of causes of death. \u0000Material and methods. The work used statistical data on the Republic of Bashkortostan. The data cover all deaths in the population aged 1 to 69 years. The “Potential Years of Life Lost” (PYLL) and short received Gross Regional Product (GRP) per capita were used as indicators for assessing economic losses. \u0000Results. The socio-economic damage from the main causes of death of the population of the Republic of Bashkortostan for 2002–2020 has been calculated. The shares of the contribution of premature mortality to PYLL in 2020 were determined for the following causes: diseases of the circulatory system (27.8%), external causes (20.8%), neoplasms (12.3%), infectious and parasitic diseases (5.9%), respiratory diseases (9.1%), diseases of digestive organs (8.6%). The overall structure of mortality by causes differed significantly from the structure of PYLL by causes. In terms of the level of damage caused per 1 death, infectious and parasitic diseases, external causes, diseases of the digestive system in men and women in 2020 significantly exceed diseases of the circulatory system, diseases of the respiratory system, and neoplasms. As a result of health losses, the economy of the Republic of Bashkortostan lost 36.9 billion rubles. or 10.43% of GRP, while considering only mortality from the main causes. \u0000Research limitations. The study was conducted on the available aggregated statistical data, primary data were not used. All calculations were carried out by the authors themselves. \u0000Conclusion. When making decisions related to the development of programs to preserve and support the health of the population, one should focus on the damage to the economy from losses associated with premature mortality, measured in potential years of life lost and short received GRP due to death.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42810102","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":"Assessment of the trend in demographic processes of population aging in the northern and equated territories of the Irkutsk region","authors":"G. Gaidarov, T. I. Alekseevskaya, O. Sofronov, Dmitry O. Kindrat","doi":"10.47470/0044-197x-2023-67-4-336-343","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-4-336-343","url":null,"abstract":"Introduction. The process of population aging, characterized by a gain in the group of people of older working age in the age structure, has begun in Russia, and in the developed countries. The demographic policy of the state is aimed at creating a favourable age and gender structure of the population with the aim of systematic socio-economic development of the regions. \u0000The purpose of the study is to give a comprehensive assessment of the trend in demographic aging of the population of the northern and equated territories of the Irkutsk region over 2011–2019. \u0000Materials and methods. The selection of territories is based on the Decree of the Government of the Russian Federation of November 16, 2021 N 1946 “On approval of the list of regions of the Far North and areas equated to regions of the Far North”. Information on the absolute size of the total population, population by gender and individual age groups was obtained from the Rosstat service for the Irkutsk region. In accordance with the methodological provisions on demographic statistics, special aging coefficients were studied in the formed statistical population using the Statistica 6.0 MS Excel 2017 software packages. \u0000Results. In the northern and equated territories of the Irkutsk region, population aging processes are taking place. The intensity of the aging process in the regions in time proceeds differently. There is a disproportion in the age-gender structure due to the feminization of aging, which leads to deformation of the age-gender pyramid. In most regions, the depth of aging is decreasing, the number of people surviving to the age group of 75–89 years is becoming smaller. There is a twofold gain in the pension burden coefficient, its trend in the regions is similar to the Irkutsk region in general, with the exception of Bratsky, Nizhneilimsky, Ust-Kutsky industrial areas. \u0000Research limitations. The method used is applicable in the study of the trend in the population aging rate in certain territories. \u0000Conclusion. The formation of a steady growth trend of indicators characterizing the processes of population aging in the territories determines the need to develop programs to improve demographic policy in the subject of the Federation.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44271439","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":"Project approach to the control the process of the provision of the health care to cases with cardiovascular diseases at the outpatient level","authors":"G. V. Artamonova, E. A. Batsina, Y. Danilchenko, S. Makarov, I. L. Strokolskaya","doi":"10.47470/0044-197x-2023-67-3-195-202","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-3-195-202","url":null,"abstract":"Introduction. Many hospital departments are involved in a single technological cycle of ensuring the quality of medical care. The discrepancy between the work of any of the divisions and patient expectations affect the perception of the medical service provided as a whole. Implementing project approach in medical care delivery process ensures its effectiveness and increases patient satisfaction. \u0000Aim: to describe the experience of using project approach to improve temporal characteristics of outpatient cardiological care services. \u0000Material and methods. Primary medical sanitary service (PMSS) and cardiovascular care provided at the polyclinic were the object of the study. Problems affecting patient satisfaction were the subject of the study; the patients of the polyclinic were followed for the purposes of this study. Expert assessments, survey, mapping analytical and statistical methods were used in the study. The group of patients was formed according to the following criteria: undergoing scheduled appointment with a physician, having the following complaints including elevated blood pressure, periodic chest pain or heart arrhythmias, provided informed voluntary consent to participate in the study. \u0000Results. According to the analysis of patients, opinion on the PMSS provided at the polyclinic — 20% of patients were “rather not satisfied” with services provided by a cardiologist, and 30% of patients were “rather not satisfied” with services provided by a physician. Patients reported the time spent waiting to a group of experts working on the National Social Initiatives. All types of patients, “time losses” were recorded in detail. Process mapping enabled us to establish the following stages: booking an appointment with a physician; undergoing examination; booking an appointment with a cardiologist and undergoing examination; follow-up examination; booking an appointment a cardiologist, undergoing examination, treatment prescription; follow-up examination. The experts identified the problems at each stage and formed proposals to increase the accessibility of outpatient care. \u0000Limitations of the study. There are several limitations of this study: it was a short-term study, the patient assessments of the situation can be subjective, and there was a small number of events involved in the process mapping. \u0000Conclusion. The project approach allows specialists to identify problems and their causes, identify areas for improvement, and develop and implement appropriate corrective measures.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45143379","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":"Nikolai Vladimirovich Pleshkov — an undeservedly forgotten Crimean doctor (on the 200th anniversary of his birth)","authors":"E. Zvereva, S. Kutia, Evgeniya M. Zanina","doi":"10.47470/0044-197x-2023-67-3-267-270","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-3-267-270","url":null,"abstract":"2023 will mark the 200th anniversary of birth of Nikolai Vladimirovich Pleshkov, who made a significant contribution to the development of the medical traditions of Taurida gubernia. There are no report devoted to his life in modern scientific literature. This article is based on the work with archival collections and pre-revolutionary literary sources. A former orphan, Pleshkov was able to receive a decent education due to his outstanding education, learned several foreign languages, and was well versed in local history, science, culture, literature, philosophy and religion; he was the author of many reports on religious and philosophical topics. In addition, he was actively involved in public life of Simferopol. He was one of the co-founders and for many years — chairman of Simferopol Doctors’ Society. During the Crimea war, the doctor worked under \u0000N.I. Pirogov. Among other things, Pleshkov is an author of the first Russian translation of Pascal’s work “Pensees”. Nowadays the former hospital building where N.V. Pleshkov worked houses the chair of Human Anatomy \u0000of the Institute “Medical Academy named after S.I. Georgievsky”. The facts of his biography, reconstructed \u0000in this article, allow not only to take a new look at the history of the development of health care in Taurida gubernia in the XIX century, but also to form the sense of continuity of passion among medical students.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44799444","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":"Premature mortality from tuberculosis and HIV infection in Russia before and during the COVID-19 pandemic","authors":"E. Tsybikova, A. V. Vladimirov","doi":"10.47470/0044-197x-2023-67-3-230-236","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-3-230-236","url":null,"abstract":"Introduction. The introduction of restrictive measures during the COVID-19 pandemic led to a reduction in the timing of screening aimed at early detection of tuberculosis among the population. As a result, there has been increased the proportion of patients with common forms of tuberculosis, the treatment of which is of considerable complexity and creates a high risk of death. \u0000Objective of research: study of premature mortality from tuberculosis and HIV infection in Russia before and during the Covid-19 pandemic. \u0000Material and methods. Rosstat data on deaths due to tuberculosis and HIV infection over 2000–2020. The age of 70 years has been adopted as the standard age for calculating the indicator of has increased potential years of life lost (PYLL). Pearson and Spearman correlation coefficients were used for the analysis. \u0000Results: In Russia, before the Covid-19 pandemic in 2000–2019, the decrease in the total number of patients who died from tuberculosis and HIV infection, and the total PYLL, occurred due to a decrease in the proportion of patients who died from tuberculosis — from 99.3% to 25.4%. Pandemics in 2020 in addition, total PYLL decreased to 45.3% or by 9%, PYLL from TB to 8.9% or by 10.1%, PYLL from HIV infections to 36.4% or by 8.9% compared to 2019. \u0000Limitations of the study. The analysis of PYLL from tuberculosis and HIV infection was carried out for the entire population and for individual age groups in 2000–2020, which was sufficient to achieve the goal. \u0000Conclusion. In Russia, during the pandemic, the main reason for the decrease in the total PYLL and PYLL from tuberculosis and HIV infection were changes in the definition of the main cause of death in the combination of tuberculosis and HIV infection with Covid-19, when Covid-19 began to be indicated as such, and tuberculosis and HIV infection moved into the category of secondary causes and ceased to take part in the formation of mortality rates from these diseases.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41420972","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":"Legal regulation of gamete and embryo donation: global and national trends (literature review)","authors":"N. Bashmakova, Irina G. Polyakova, E. Symaniuk, A. Khramtsova","doi":"10.47470/0044-197x-2023-67-3-252-258","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-3-252-258","url":null,"abstract":"While the assisted reproductive technologies have been available for several decades, there still exists a great divergence in legal frameworks regulating reproductive donation. \u0000The article discusses legal regulations on embryo and gamete (sperm and oocytes) donation in Europe, Americas, Canada and Australia. The search for publications was carried out in all available bibliographic and abstract databases (RSCI, Scopus, Web of Science, CyberLeninka, eLibrary, PubMed) containing reports on the subject of the article. The main search restrictions were the language of publications (English and Russian) and the date of reports (not earlier than 2000). We seek to chart global trends and identify major legislative “gaps”; the latter emerge because each type of reproductive donation causes specific conflicts and calls for specific regulations. There is a visible trend towards open gamete donation across the globe as more and more governments insist on deanonymization of donors. Legislators intend to protect children’s interests and to secure their right to identify their biological parents. Financial remuneration is perceived differently, and regulations diverge across the globe. Many governments permit reimbursements, but do not allow any commercial payoffs. Yet, issues of parenthood and donor-recipient obligations remain quite controversial, which results in divergent legal frameworks. Sperm donation is the least controversial and safest procedure; therefore, it is legal in all countries and is allowed in non-medical setting. On the other hand, informal sperm donation requires targeted legal regulations. Parenthood and anonymity in sperm donation also cause concern and require specific legislation. In some countries, oocyte donation is illegal while in others it is under severe limitations. Currently medical treatment and observation of oocyte donors after ART cycles is not yet legally regulated, which leaves women unprotected from post-donation health issues. Embryo donation hinges on the status of the embryo. Specific definition will determine the consequences including from adoption to research use. There remains a problem of authority over embryo’s future in cases of a spouse’s death or divorce.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41688004","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":"Accessibility of medical care in the public and private sectors of healthcare (based on the results of a sociological survey of the population of the Vologda region)","authors":"K. Kalashnikov","doi":"10.47470/0044-197x-2023-67-3-203-210","DOIUrl":"https://doi.org/10.47470/0044-197x-2023-67-3-203-210","url":null,"abstract":"Introduction. In the Vologda region healthcare there are complex management and economic (acute shortage of doctors) and spatial (large territory, complex settlement system) restrictions on the availability of medical care. The private health sector is an alternative to the public sector, but it expands the burden of public spending. This actualizes research aimed at assessing the availability of medical care in both sectors of the industry. \u0000Purpose of the study. Assessment of the availability of medical care for the population of the Vologda region in the public and private sectors. \u0000Materials and methods. The toolkit is a questionnaire survey of the population (sample consisted of 1,500 people) conducted in the region in 2018 and 2020. The analysis is carried out by means of the distribution of respondents’ estimates, expressed in specific weights of the total amount of responses, in the comparative context of demographic and territorial groups, the public and commercial sectors of the industry. The integral index of accessibility of medical care is proposed and tested. \u0000Results. Respondents estimate the availability of medical care/services in private medical institutions higher than in public ones (the accessibility index (AI), in 2020 was 179.6 and 163.4, respectively). During the study period, the index increased, but the gap between sectors remained. The lowest subjective estimates of accessibility were received by medical care in rural areas (AI for the public sector — 167.8, private — 179.5) and in Cherepovets (AI accounted of, respectively, 148.1 and 151.4). The highest level of accessibility was found in small towns (AI was 177.6 and 194.8). \u0000Limitations. When studying the availability of medical care in the region, 1,500 questionnaires were evaluated, which represents a sufficient reference sample to solve the tasks set. \u0000Conclusion. The study allowed obtaining valuable results, which, along with the developed tools (in particular, the index of accessibility of medical care), are recommended to the authorities for monitoring the situation in the healthcare of the region.","PeriodicalId":39241,"journal":{"name":"Zdravookhranenie Rossiiskoi Federatsii / Ministerstvo zdravookhraneniia RSFSR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41795611","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}