2017 № 4 Mortality rate in the Russian Federation in 2006-2015
Aim-сomparative analyses of age peculiarities and nosological structure in mortality causes in 2006 and in 2015 in the Russian Federation. Rosstat’s data of male and female population size and the number of dead as well in 5-years age groups for the years 2006 and 2015 were used. Standardised all-causes mortality coefficients were calculated using Kitagava’s formulae, comparison in 5yaers age groups was conducted. Nosological mortality structure based on Rosstat’s mortality causes nomenclature analyses was made. Percentage of each mortality cause was assessed; level of increase/ decrease was calculated for the completely identical groups. The mortality rate decreased by 13,6% in 9 years, the standardized rate dropped by 25,9%. The main decline was at the age of 25-29 (by 46,6%) and an the age of 1-4 (by 45,7%). The less change was an the age 90-94 (by 9,5%). More intensive dynamics in male was determined by the initial male «overmortality». The percentage of diseases of the circulatory system in all death’ cases was 48,7% in 2015 comparing to 56,9% in 2006; external causes had 7,7% and 9,9%; Neoplasms - 15,7% and 13,1%; diseases of the respiratory system - 3,97% and 3,8%; diseases of the digestive system - 5,3% and 4,1% respectively. The percentage of the mortality causes as «Senility» increased in 2,7 times. The highest percentage in the mortality causes in 2006 as well in 2015 falls on «Atherosclerotical heart disease» (12,5%). Mortality rate decline was determined, among others, by the realization of the state demographic policy and the task programs in health care. The mortality causes structure has changed because of the significant decline in the portion of diseases of the circulatory system and of external causes. Rosstat’s additional list of mortality causes which had no defined clinical criteria for the diagnosis had a certain influence, and MoH RF recommendations to use the «Senility» code as a cause of death since 2014, as well.
2018 № 1 Experience of use of medico-economic standards for the endovascular treatment of diseases
Endovascular surgery and interventional radiology is the most modern technologies in interventional medicine. The standardization of endovascular methods is the main condition for application in practice.
Materials: Reports of the main specialists on X-ray and endovascular diagnostics and treatment of MZRF and MZ of the Moscow region. Regional medico-economic standards (MES) for endovascular treatment of diseases are developed and implemented by the Ministry of Health of the Moscow Region in 2012-2014. The results of the work showed a significant increase (6,4 times) of the performed endovascular procedures for various diseases in medical organizations involved in the implementation of the Moscow region Medical Insurance Program. This made it possible to increase the efficiency of the work of cardiology, surgery, oncology and gynecology departments, to reduce hospital mortality from acute myocardial infarction in vascular centers from 22 in 2012 to 7-8% in 2015, and mortality from cardiovascular dis¬eases in the Moscow Region from 878.5 in 2012 to 680.5 in 2015 per 100 thousand of the population. The opening of 10 catheterization centers in the Moscow region, the introduction of MES treatment of patients with acute coronary syndrome according to routing, ensured the effective hospitalization of patients in "invasive" centers from 2% in 2012 to 82.8% in 2015. The standardization of the endovascular methods of treatment leads to an increase in the use of hospital beds, improved routing of patients' flows, provision of endovascular care of patients.