Социальные аспекты здоровья населения最新文献

{"title":"COMPARATIVE ANALYSIS OF PATIENT SATISFACTION WITH MEDICAL CARE PROVIDED BY GENERAL PRACTITIONERS AND DISTRICT PHYSICIANS","authors":"Artem Volnukhin, Tatiana Morozova, Galina Skvirskaya, Elena Samokhina, Andrey Reze, Tatiana Zaugol’nova, Tatiana Pomytkina, Nina Zhernakova, Anatoly Stremoukhov, Anna Gertsog","doi":"10.21045/2071-5021-2023-69-2-2","DOIUrl":"https://doi.org/10.21045/2071-5021-2023-69-2-2","url":null,"abstract":"Significance. Patient satisfaction with medical care is one of the key performance indicators of the health care system. The purpose of the study: to conduct a comparative analysis of patient satisfaction with primary care provided by general practitioners (GP) and district physicians (DPh) in Russia and identify indicators that can be used to manage accessibility and quality of primary care, using the principles of value-based healthcare. Material and methods. The study used analytical, sociological and statistical methods. The survey was conducted by the method of sampling. The minimum sample size equaled to 400 observation units. The survey bases included medical organizations providing medical care on an outpatient basis in the cities of Moscow, Kemerovo and Belgorod, the places that have undergone reforming and introduced GP practices. Results. The final analysis included 415 questionnaires. Patient satisfaction with medical care, provided by GP equaled to 87.6%, satisfaction with care provided by DPh added up to 73.3% (p<0.001). Patient satisfaction with individual parameters of medical care related to the medical organization, doctor and doctor-patient relationship also turned out to be statistically significantly higher if provided by GP. The average score ranged within 3.8-4.2 and 2.2-2.4, respectively. For both the GP and DPh models of care delivery, the lowest satisfaction was reported for the parameters characterizing its organization. Based on the results of our own research and results of earlier papers, the indicators of primary care accessibility and quality that are of greatest value to the patient were identified. Conclusion. Based on generalization of the study results and data published in scientific literature, a set of indicators has been proposed to ensure continuous monitoring over quality and accessibility of primary care and make organizational and managerial decisions using the principles of value-based healthcare.","PeriodicalId":494950,"journal":{"name":"Социальные аспекты здоровья населения","volume":"227 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135355618","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":"MONITORING AND EVALUATION OF MICROBIOLOGICAL DIAGNOSTICS OF TUBERCULOSIS: RESOURCES AND PERFORMANCE OF MICROBIOLOGICAL LABORATORIES","authors":"Yuliya Mikhaylova, Nadezhda Mezentseva, Sergey Sterlikov, Aleksandr Mikhaylov, Yana Pankova","doi":"10.21045/2071-5021-2023-69-2-10","DOIUrl":"https://doi.org/10.21045/2071-5021-2023-69-2-10","url":null,"abstract":"Significance. The system of microbiological diagnostics is of key importance for organizing microbiological diagnostics in accordance with the modern recommendations, and fulfilling political commitments of the Russian Federation within the framework of the End TB Strategy Purpose: to assess the availability, use and results of the modern methods of microbiological diagnostics of tuberculosis in Russia in 2021. Material and methods. The study has analyzed forms #7-TB, ВР-4БЛ, ВР-1Ф of official statistical observation, results of external quality assessment of laboratories (Interlaboratory comparison system “Federal System of External Quality Assessment of Clinical Laboratory Testing (FSEQA)”). Results. The share of patients with pulmonary tuberculosis with a smear positive Ziehl-Nelsen, detected in medical organizations providing primary health care (PHC) decreased to 12.8%, while the share of new smear positive pulmonary TB patients increased to 37.4%; the share of newly diagnosed patients with pulmonary tuberculosis with a positive result of sputum bacterioscopy among patients with cavities increased to 60.6%.The share of laboratories with satisfactory results of the FSEQA participation regarding smear microscopy increased to 92.8%; the share of laboratories with the confirmed quality increased to 14.3%. The culture coverage of new pulmonary TB patients equaled to 98.0%. Culture-based confirmation of the diagnosis was obtained in 55.3% of the patients; the share of smear positive new pulmonary TB patients with the negative culture result decreased to 3.8%. The share of laboratories participating in FSEQA increased to 44.5%; the share of laboratories that showed satisfactory results - up to 90.8%, the share of laboratories with the confirmed quality - up to 40.4%. The coverage with molecular genetic testing added up to 90.8%. The drug susceptibility testing (DST) coverage equaled to 97.7%. The patient coverage with rifampicin resistance DST to fluoroquinolones reached 93.2%; coverage with pre-XDR-TB DST to linezolid - 35.0%, bedaquiline - 12.4%. Conclusion. Microbiological diagnostics of tuberculosis in PHC by smear microscopy is ineffective in modern conditions; there are prospects for its use in new Russian regions. The COVID-19 pandemic failed to produce any significant negative impact on the patient coverage with microbiological examination methods. In 2020–2021, the quality of bacterioscopic and culture testing for tuberculosis increased. DST coverage for bedaquiline and linezolid is poor; this does not allow to meet the current clinical guideline requirements. The cost of consumables per patient increased 3.1 times between 2015 and 2021.In the structure of financial expenses on TB microbiological diagnostics, consumables that require import substitution prevail. Scope of application. The study results can be used by heads of health authorities, chief physicians of TB facilities, heads of microbiological laboratories in order to increase ef","PeriodicalId":494950,"journal":{"name":"Социальные аспекты здоровья населения","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135355949","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":"PROVISION OF MEDICAL ORGANIZATIONS OF THE FAR EASTERN FEDERAL DISTRICT OF THE RUSSIAN FEDERATION WITH OBSTETRICIAN-GYNECOLOGISTS, 2017 - 2021","authors":"Maksim Stupak, Maisa Ivanova, Ivan Deev, Olga Kobyakova","doi":"10.21045/2071-5021-2023-69-2-8","DOIUrl":"https://doi.org/10.21045/2071-5021-2023-69-2-8","url":null,"abstract":"Significance. Relevance. In conditions of demographic trouble, the study of the provision of the female population with obstetricians and gynecologists is of high relevance for the implementation of tasks to preserve the reproductive potential of women and the adoption of managerial measures to solve the personnel problem. Purpose of the study. To study the provision of medical organizations of the Far Eastern Federal District with obstetricians and gynecologists. Material and methods. The analysis of the availability of obstetrician-gynecologists was carried out on the data presented in the form No. 30 and statistical collections of the Ministry of Health of Russia for the period from 2017 to 2022. in the context of federal districts and subjects of the Far Eastern Federal District. The following were used in the work: retrospective analysis, statistical (descriptive statistics), analytical method, descriptive statistics method. Results. The provision of medical organizations with obstetrician-gynecologists in the Russian Federation over the past five years has decreased by 4.4%, in the Far Eastern Federal District - by 13.2%, in the Khabarovsk Territory - by -2.1%. At the same time, for the entire study period in the Far East region, the indicator exceeds the average Russian level. There is a widespread decline in the provision of obstetrician-gynecologists, especially in the Far Eastern Federal District (-13.2%), the Urals (-8.9%) and the Volga (-8.7%) federal districts. Among the subjects of the Far Eastern Federal District, the most favorable situation is in the Chukotka Autonomous Okrug (from 8.6 to 10.7 per 10,000 population) and the Magadan Region (from 7.7 to 8.5 per 10,000 population). In most subjects of the Far Eastern Federal District, the provision exceeds the district level.At the same time, the availability of doctors - specialists providing medical care in stationary conditions, over the same period in the Far Eastern Federal District decreased by 19.5%, in the country as a whole - by 8.0%. In half of the subjects of the Far Eastern Federal District, the availability of specialists is higher than the district value, especially in the Chukotka Autonomous District (by 2.7 times in 2017 and 2.9 times in 2021), while in the Khabarovsk Territory it does not reach the district level. Conclusion. Over the past five years, there has been an annual decrease in the provision of medical organizations with obstetrician-gynecologists. This is especially typical for the Khabarovsk Territory and the Far Eastern Federal District as a whole. The availability of doctors providing medical care in stationary conditions is also declining. At the same time, in half of the subjects of the Far Eastern Federal District, the availability of specialists remains above the district value. Application area. The results of the study can be applied when planning a program of state guarantees for the provision of free primary specialized medical and sanitary and","PeriodicalId":494950,"journal":{"name":"Социальные аспекты здоровья населения","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135355615","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":"ALGORITHM FOR ASSESSING THE RISK OF MICROVASCULAR COMPLICATIONS IN PATIENTS WITH DM FOR A DOCTOR'S DECISION SUPPORT SYSTEM","authors":"Nikolay Pervyshin, Alexandr Lebedev, Elena Lebedeva, Rudolf Galkin","doi":"10.21045/2071-5021-2023-69-2-12","DOIUrl":"https://doi.org/10.21045/2071-5021-2023-69-2-12","url":null,"abstract":"Relevance: most experts agree that regular and high-quality dispensary monitoring of patients with diabetes mellitus at the outpatient stage is a necessary condition for preventing the development of vascular complications. The solution of this problem is closely connected with the development and widespread clinical implementation of digital healthcare tools, automated workplaces of doctors, decision support algorithms. Objective: to improve the quality and effectiveness of outpatient care for patients with type 2 diabetes mellitus by digitalizing outpatient admission, using the software of the automated workplace of an endocrinologist (AWPE DM), developing an algorithm for assessing the risk of microvascular complications as an element of a decision support system. Materials and methods: based on the analysis of the results of clinical experience in the use of ARME DM, an algorithm for assessing the risk of microvascular complications has been developed, which allows optimizing the complex of measures for dispensary observation of patients with type 2 diabetes mellitus. Results: demonstrated an increase in the efficiency and quality of medical care for patients with type 2 diabetes mellitus when using AWPE DM in clinical practice; developed a digital algorithm for assessing the risk of microvascular complications, providing stratification of the risks of their development according to the selected criteria for each of the classes; determination of a sufficient minimum of dispensary laboratory and instrumental studies, taking into account the level of credibility of recommendations; personalized correction of therapeutic goals of treatment taking into account the individual characteristics of the patient, including the stage of chronic kidney disease and diabetic retinopathy. Conclusions: the clinical application of the algorithm for assessing the risk of vascular complications, developed taking into account current domestic and foreign clinical recommendations, allows objectively in numerical values to assess the probability of progression of certain classes of microvascular complications of diabetes mellitus in a particular patient, to determine the activities of a personalized program of dispensary observation and rehabilitation. For laboratory and instrumental verification, examinations with the greatest diagnostic significance and suitable for storage and processing in digital format are proposed. Based on the results of the risk assessment directly during the outpatient appointment, the algorithm forms recommendations for the differentiated choice of therapeutic treatment goals, which makes it possible to optimize the personalized program of dispensary observation of the patient.","PeriodicalId":494950,"journal":{"name":"Социальные аспекты здоровья населения","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135355616","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 ROLE OF HIERARCHICAL CHANGES IN THE ENVIRONMENTAL FACTORS OF THE CAUSE-OF-DEATH MORTALITY STRUCTURE","authors":"Yaroslav Leshchenko, Alexandr Lisovtsov","doi":"10.21045/2071-5021-2023-69-2-7","DOIUrl":"https://doi.org/10.21045/2071-5021-2023-69-2-7","url":null,"abstract":"When identifying changes in the health status of the population, it is relevant to study the modern structure of diseases. The purpose of the study is to assess the quantitative and structural changes in mortality associated with factors of different origin in the process of evolution of the regional anthropological ecosystem. Material and methods. Rates and structure of male mortality in the Irkutsk region for the period from 1990 to 2020 have been analyzed. The study used standardized mortality rates according to the European standard population. The trends were evaluated through linear models using standard Excel tools. Significance of the trend equation was calculated using F-test (IBM SPSS Statistics 23). Results. At the 1st stage (1990-1991), the structure of mortality was dominated by: diseases of the circulatory system (34.9%), neoplasms (17.6%), external causes (27.7%), and respiratory diseases (7.4%). At the 2nd stage (1992-2005), the situation was mainly determined by psychogenic factors. Those impacts are indicated as follows: sharply increased mortality from acute vascular heart and brain damages, suicide, murder and accident. At the 3-d stage (2006-2019), along with improvements in the socio-economic situation, the mortality rate was decreasing, especially across the following disease classes: diseases of the circulatory system (from 1237.3 to 785.5o/oooo), external causes (from 553.3 to 228.4o/oooo), respiratory diseases (from 182.2 to 75.2o/oooo). A long-term trend towards increasing mortality from infectious and parasitic diseases was identified. No trend in the dynamics in mortality from diseases of the digestive system was registered. Significant changes in the structure of mortality were noted for infectious and parasitic diseases, respiratory diseases, and digestive diseases indicating a phenomena of pathomorphosis. Since 2020, a new socio-ecological situation has begun to take shape due to the COVID-19 pandemic. A new coronavirus infection has become a powerful factor of pathomorphosis and restructuring of the entire socio-ecological system. Conclusion. Disease development and the relevant mortality are associated with hierarchical changes in the impact of factors of different origin (socio-economic, psychogenic, epidemiological) on the population. Pathomorphosis suggests unfavorable structural changes in the medical, demographic and socio-ecological status of the population.","PeriodicalId":494950,"journal":{"name":"Социальные аспекты здоровья населения","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135356156","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 ECONOMIC BURDEN OF EYE DISEASES AND GLAUCOMA IN THE LIPETSK REGION IN 2014-2021","authors":"Esedulla Osmanov, Vladimir Reshetnikov, Denis Efimov, Rustam Manyakov, Liliya Tuktamysheva, Amina Garaeva, Lida Elzhurkaeva, Mata Tokaeva","doi":"10.21045/2071-5021-2023-69-2-6","DOIUrl":"https://doi.org/10.21045/2071-5021-2023-69-2-6","url":null,"abstract":"Significance. The problem of low vision and blindness is one of the most important public health challenges, due to both medical and social significance, and the increasing prevalence of visual impairments around the world. Purpose: to assess the economic burden of eye diseases and glaucoma in the Lipetsk region in 2014-2021. Material and methods. The burden of eye diseases was calculated on the basis of registers of invoices for medical care provided by medical organizations to the territorial fund of compulsory medical insurance of the Lipetsk region in 2014-2021. The cost of outpatient care, inpatient care, high-tech medical care (HTMC), hospital replacement and emergency medical care has been calculated. Results. In 2014-2021, the cost of outpatient care delivery to patients with eye diseases added up to 919,071.8 thousand rubles, inpatient care - 1,127,393.4 thousand rubles, care provided in day hospitals - 482,876.8 thousand rubles, emergency medical care - 2,743.5 thousand rubles, HCMC- 122,391.1 thousand rubles, the share of expenses for medical care delivery to patients with glaucoma in the cost structure of eye diseases equaled to 7.2%, 16.0%, 4.1%, 18.3% and 59.3% respectively. The amounts spent on HTMC provision to patients with glaucoma in 2015-2019 accounted for the vast share of the cost of HTMC delivery to patients with eye diseases, ranging from 92.0% to 98.7%. A 13.2-fold increase in the cost of medical care delivery to patients with eye diseases in day hospitals has been identified, which is not true for glaucoma, the cost of which has increased 1.3-fold. In the glaucoma cost structure, the cost of outpatient care accounted for 19.4%, on average, while the cost of inpatient medical care - 53.1%, the cost of care delivery in day hospitals and emergency medical care did not exceed 6.0% on average, while the cost of high-tech medical care accounted for 21.4%. Dynamics in the share of the gross regional product of the Lipetsk Region spent on medical care delivery to patients with eye diseases in the pre-pandemic period was characterized by a rise, reaching 0.082% in 2019. Conclusion. From 2014 to 2021, the cost associated with medical care delivery to patients with eye diseases and glaucoma increased. The share of the gross regional product (GRP) spent on medical care delivery to patients with eye diseases is characterized by a rise, adding up to 0.082% in the pre-pandemic period. The cost of medical care delivery to patients with glaucoma accounts for a significant share in the cost structure of eye diseases (12.8% on average). In the glaucoma cost structure, on average, inpatient ophthalmological care accounts for 53.1%, HTMC – for 21.4%, and outpatient care - 19.4%. Scope of application. The undertaken cost assessment associated with medical care delivery to patients with eye diseases and glaucoma is necessary for effective economic planning in the public health system.","PeriodicalId":494950,"journal":{"name":"Социальные аспекты здоровья населения","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135355617","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":"DISTRICT PEDIATRIC SERVICE: STAFFING TRENDS IN A LARGE AGRO-INDUSTRIAL REGION","authors":"Andrey Redko, Vladimir Khan, Viktoria Martynenko","doi":"10.21045/2071-5021-2023-69-2-9","DOIUrl":"https://doi.org/10.21045/2071-5021-2023-69-2-9","url":null,"abstract":"Significance. Timely monitoring over human resources makes it possible to identify reserves for improving accessibility, quality and effectiveness of pediatric primary care delivery. The purpose of the study. To evaluate dynamics in staffing with district pediatricians in the Krasnodar Territory. Material and methods. The material included data of the state statistical observation form No. 30 “Information about a medical organization” in 2010-2021, depersonalized data from the register of the assigned population of the Krasnodar Territory and the regional register of medical workers as of 01.01.2022. Statistical and analytical methods were used. Results. In the Krasnodar Territory there are 76 medical organizations with the position of district pediatrician. The total staffing of the district service with pediatricians equals to 1,307 positions, staffed by 1,071 individuals (81.9%). The estimated deficit between the number of positions and the number of individual district pediatricians is 250 specialists. The share of specialists of the pre-retirement and retirement age is high. During the period under review, against the background of a general decrease in the number of individual doctors in the region by 5.1% (p<0.001), there was a 12.6% (p<0.001) increase in the number of district pediatricians. The growth rate of the pediatric population in the region exceeded the one among individual district pediatricians, resulting in a 6.0% decrease in the population-to-doctor ratio(p<0.001). The undertaken in-depth analysis shows that 34% of the district pediatricians have a 1.5-fold and higher workload than the recommended one. In conditions of excessive workload of district pediatricians, primary care services are provided to about 620,000 children. The mean age of a district pediatrician in the Krasnodar Territory equals to 47 ± 0.3 years, however, about half of all doctors in the analyzed group are specialists of the pre-retirement and retirement age. A combined analysis of the age structure of pediatricians and size of the facility catchment areas shows that 30.8% the of district doctors aged over 60 have a workload that is higher than the recommended standards. Conclusion. A wider range of methods to monitor the population-to-district pediatrician ratio and the use of both traditional and advanced methods of analysis based on the register of the assigned population and the register of medical workers will make it possible to identify problem areas in the industry and promptly meet the changing staffing needs of the district pediatric service. Scope of application. The study results can be used to plan and implement personnel programs aimed at eliminating personnel shortages and imbalances.","PeriodicalId":494950,"journal":{"name":"Социальные аспекты здоровья населения","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135783273","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":"DEVIATION OF BODY WEIGHT AT BIRTH AS A RISK FACTOR FOR CHILD HEALTH","authors":"Karina Moiseeva, Dmitry Ivanov, Vadim Yuriev, Anna Alekseeva, Kseniya Shevtsova, Shalva Harbedia, Anna Zastupova, Viktoriya Danilova","doi":"10.21045/2071-5021-2023-69-2-4","DOIUrl":"https://doi.org/10.21045/2071-5021-2023-69-2-4","url":null,"abstract":"Significance. The problems of public health deterioration are of great importance for the state socio-economic potential. The most vulnerable group is the child population in the first years of life, especially during the neonatal period. Accordingly, effects of the birth weight deviation on the child health are a focus of high research interest. Purpose. To assess the body weight of born alive newborns, and identify effects of the deviation of body weight at birth on the child health in the Northwestern Federal District. Material and methods. Based on official statistics for 2017-2021, distribution of children by birth weight, neonatal morbidity rates in Russia, the Northwestern Federal District as a whole and its regions in dynamics have been analyzed. A nonparametric Spearman rank-order correlation method was used to assess effects of the baby weight at birth on the newborn health. Statistical data processing was carried out using MS Office-2016 and StatSoft-Statistica 10.0 software packages. Results. The Northwestern Federal District is characterized by a higher, in comparison with the Russian Federation, share of children with a birth weight of more than 4000 g (11.33% vs. 10.12%; p<0.05) and less than 2500 g (6.15% vs. 6.05%; p<0.05). In the Federal district, there is a negative growth dynamic in the share of newborns with high body weight and low birthweight of less than 1500 g. The average District neonatal morbidity rate significantly exceeds the national average (413.8‰ vs. 315.5‰; p<0.05), and tends to increase due to the increased neonatal morbidity in almost all regions of the Federal district. The correlation analysis has identified a direct strong relationship between the number of children born sick and got ill, and the number of babies with low and high weight at birth (rxy=0.83-0.99). Conclusion. The increased number of underweight babies and newborns born with a body weight of 4000 g or more is a regional risk factor for a high incidence rate in the District regions.","PeriodicalId":494950,"journal":{"name":"Социальные аспекты здоровья населения","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135355620","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":"DYNAMICS in MORTALITY FROM MYOCARDIAL INFARCTION over A 10-YEAR PERIOD IN THE RUSSIAN FEDERATION, THE NORTHWESTERN FEDERAL DISTRICT AND THE KALININGRAD REGION, 2012 - 2021","authors":"Robert Bogachev, Larisa Mikhailova, Kirill Shcherbanev, Fatima Yunusova","doi":"10.21045/2071-5021-2023-69-2-1","DOIUrl":"https://doi.org/10.21045/2071-5021-2023-69-2-1","url":null,"abstract":"Significance. Among cardiovascular diseases, myocardial infarction is the most frequent cause of death in the majority of regions of the Russian Federation. Regional peculiarities of the cardiovascular condition development and clinical course have high impact on many aspects of its diagnosis and treatment. The purpose of the study: to determine patterns of mortality from myocardial infarction in the Russian Federation, the Northwestern Federal District and the Kaliningrad region in the period from 2012 to 2021. Material and methods. Mortality rates from myocardial infraction in the regions of the Northwestern Federal District over a 10-year period (2012 -2021) were analyzed and calculated based on data of the Unified Interdepartmental Information and Statistical System of the Russian Federation. Data calculations and graphical analysis were performed using the Microsoft Excel package of application programs. Results. The study has undertaken a comparative analysis of statistical indicators of myocardial infarction mortality in Russia as a whole and in the regions of the Northwestern Federal District, including the Kaliningrad region. Over ten years, from 2012 to 2021, the Russian Federation saw a stable reduction in the myocardial infarction mortality rates from 47.1 cases per 100 000 population in 2012 to 38.27 cases per 100 000 population in 2021. On average, mortality from myocardial infarction in the Northwestern Federal District is higher than in Russia as a whole during the period under study, there was a steady decline from 57.6 in 2012 to 42.48 per 100 000 population in 2021. Among the Northwestern Federal District regions, the highest mortality rate was registered in the Pskov region: on average, 58.32 per 100 000 population and in St. Petersburg: on average, 54.64 per 100 000 population over 10 years, while the lowest one - in the Kaliningrad region: on average, 25.38 per 100 000 population. In the Kaliningrad region, as well as in the whole Russian Federation, there is an increase in mortality from myocardial infarction registered in 2021, which is probably due to the COVID-19 epidemic. Conclusion. Since a high incidence of cardiovascular diseases and high mortality from myocardial infarction are mainly due to a low patient awareness, it is necessary to implement regional programs aimed at increasing public awareness of risk factors and symptoms of cardiovascular diseases, as well as long-term follow-up programs for acute coronary syndrome survivors. Scope of application. Comparative aspects of statistical indicators of mortality from myocardial infarction reflect effectiveness of primary and secondary prevention measures in patients with coronary atherosclerosis carried out in regional health care institutions and will contribute to better planning and implementation of regional programs aimed at reducing mortality from cardiovascular complications","PeriodicalId":494950,"journal":{"name":"Социальные аспекты здоровья населения","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135355622","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":"ORGANIZATION OF MEDICAL CARE DELIVERY TO CHILDREN WITH CONSEQUENCES OF PERINATAL CONDITIONS: PROBLEMS AND REGIONAL FEATURES","authors":"Tatyana Sokolovskaya, Valery Stupak","doi":"10.21045/2071-5021-2023-69-2-5","DOIUrl":"https://doi.org/10.21045/2071-5021-2023-69-2-5","url":null,"abstract":"Significance. Consequences of perinatal conditions do not have a clear definition, with the exception of lesions of the nervous system, for which there are certain classifications (2003, 2009). At the same time, perinatal conditions in the future may become a predictor of cerebral asthenia (36.0-72.0%); speech disorders (30.0-50.5%), mental retardation (30.0%); disorders of the emotional-volitional sphere (29.2%), early childhood autism (12.3%), problems of behavior and attention (7.7%); disorders of visual perception (20.0-30.0%) or hearing (6.0-7.0%), and according to some data, cognitive problems in adulthood. However, despite the developed criteria for implementation and needs, target indicators, available best regional practices, there are still problems in organizing medical care delivery to children suffering from consequences of perinatal conditions. Purpose of the study: to analyze the existing problems related to the organization of medical care deliver to children with consequences of perinatal conditions at the regional level. Material and methods. Continuous single-stage study in medical organizations of the Arkhangelsk region. Respondents included parents of children with consequences of perinatal conditions with disabilities, aged 8-12 years (ntotal = 162, ntest = 62). Data processing was carried out in the STATISTICA 13 program using descriptive statistics (calculation of M, Me, SD, 95% CI), correlation analysis to identify the relationship between the considered characteristics at p ≥ 0.05, and Student's t-test to determine statistical significance of differences. Results. In the structure of perinatal conditions associated with disability in children, diseases of the nervous system dominated - 62.90% (n = 39), followed by mental disorders - 16.13% (n = 10), with congenital malformations ranking third (6.45%; n = 4). The greater the time lag between the time of the disease diagnosis associated with disability and the disability itself, the worse the physical and mental functioning of the child (11.80±6.60 and 11.52±6.72; p = 0.0001), and the less pronounced the psycho-emotional and social disorders (8.29±6.09 and 6.80±5.36; p = 0.0000001). Being under medical follow-up directly affected the child rehabilitation (t= 3.61; p = 0.0006; r = 0.40 at p ≤0.05). At the same time, only 55.84% of the children (n= 34) had an individual follow-up program or the program was developed prior to going to kindergarten and/or school. Conclusion. The analysis shows a number of problems related to medical care delivery to children with consequences of perinatal conditions: untimely registration for medical follow-up; disruption of the schedule of appointments with narrow specialists, envisaged by the current Procedure","PeriodicalId":494950,"journal":{"name":"Социальные аспекты здоровья населения","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135181732","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}