Articles from rubric: «POPULATION HEALTH»
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2023 № 6 The use of natural and climatic factors of North Ossetia in the treatment and rehabilitation chronic respiratory pathology.
The effectiveness of treatment of patients with chronic respiratory pathology largely depends on an integrated approach that includes successive stages, including climate therapy in combination with natural factors.
T h e p u r p o s e of the study: to analyze the activities of the republican center for pulmonological care and to show the importance of using the natural and climatic features of North Ossetia in the treatment and rehabilitation of patients with chronic respiratory pathology.
R e s e a r c h m e t h o d s : statistical, expert assessments, direct observation. The statistical reporting materials of the Republican Center for Pulmonological care for 2018–2022 were analyzed.
R e s u l t s . The expediency of organizing local specialized medical rehabilitation organizations and their relevance in the republic is shown.
The activity of the pulmonological center became especially relevant in the post-ovarian period, when the need for rehabilitation measures for people who have had a coronavirus infection COVID‑19 has significantly increased. At the end of 2021, the flow of patients to the pulmonology center increased significantly compared to 2020. The growing trend in the number of patients treated with chronic respiratory pathology was noticeably manifested in 2022. Beds for the treatment of chronic obstructive pulmonary disease have been the most in demand for all years. In relation to 2020, the number of people treated in 2022 increased by 44.8%. Despite the fact that bronchial asthma occupies the second place in the structure of hospitalization for pulmonological beds, a more noticeable increase in patients is registered with chronic bronchitis (by 30%) and bronchiectatic disease (by 23.8%). The number of people treated with asthma and asthmatic status increased by 18.3% in 2022. More than 70% of the treated patients were persons over the working age. Taking into account the specifics of respiratory pathology, the expediency of organizing local specialized medical and rehabilitation medical organizations located in climatic conditions familiar to patients that do not require acclimatization is important. The organization of local pulmonological centers in the region is of particular importance for carrying out medical and rehabilitation measures for people with impaired respiratory system function after suffering from COVID‑19 coronavirus infection. The identified trends should be taken into account when planning the volume
of specialized medical care in the republic. -
2023 № 5 Arterial hypertension among children and adolescents as a prognostic risk factor. Problems of diagnosis.
An analysis of modern studies has shown that arterial hypertension, detected in childhood, is one of the main risk factors for both cardiovascular diseases and the progression of renal failure in subsequent age periods, which indicates the importance of early diagnosis, treatment and prevention of this condition among children and children. teenagers. The increase in the prevalence of hypertension among children and the associated health risks actualize the issues of the level, methods, techniques and frequency of blood pressure screening, differentiation of primary and secondary hypertension for successful treatment and control of the disease, as well as the development of
methods for analyzing multiple factors for accurate diagnosis and prediction of spread. arterial hypertension. Of greatest research interest are the issues of accurate measurement of blood pressure during routine medical examinations of children, including invasive or noninvasive methods for measuring blood pressure in newborns, the availability of proven equipment and specialists in pediatric hypertension, and the interpretation of blood pressure measurements. -
2023 № 5 Evaluation of commitment to a healthy lifestyle among the students of a medical university as the basis for the formation of preventive programs.
A student’s commitment to a healthy lifestyle (HLS) is determined by their values, worldview, level of awareness about the risk factors and knowledge of the measures to reduce them, where the result of programs for the formation of health skills depends, in turn, on the commitment of a particular person to the implementation of certain recommendations. To manage healthy lifestyle programs, sertain tools are needed to assess the level of knowledge and readiness to comply with health-preserving guidelines.
Objective of the study: to study the informational and behavioral component of the commitment to a healthy lifestyle of medical students.
Methods and materials. 686 students of the first (368 people) and third (320 people) courses were selected for the study of commitment to a healthy lifestyle. With the help of the questionnaire “Awareness of the main parameters of a healthy lifestyle” and the questionnaire “Study of a healthy lifestyle”, according to a specially developed methodology, the awareness of the main parameters of a healthy lifestyle, the degree of their implementation by the respondent and the opinion about the factors influencing the formation of a healthy lifestyle were studied. Statistical processing of the results was carried out using the programs Statistica 5.0 and Microsoft Office Excel.
Results. The main factors influencing the commitment to a healthy lifestyle among medical students are low levels of awareness of the theoretical foundations of a healthy lifestyle and motivation to maintain it. Negative trends in commitment to a healthy lifestyle are more clearly manifested by the third year: students’ self-evaluation of their own health is falling, the proportion of respondents who assess their health as “mediocre” and “bad” is growing, the proportion of students with optimal physical activity and normal body weight is decreasing.
Gender differences were found: young men are less committed to taking care of their own health.
The ranking of risk factors according to the degree of influence on health showed that, according to the students, the leading factors are those directly related to their lifestyle: systematic lack of sleep and study overload. Opposite opinions of students on the influence of certain factors on their health were found, which may be due to both the lack of information and its incorrect interpretation. Objectivity of the assessment of students’ awareness of the main parameters of a healthy lifestyle using an individual scoring showed that the average score of “awareness” of the first year is 3.8, the third – 8.2 points. The point expression of awareness can be used in assessing the effectiveness
of the theoretical part of the programs for the formation of a healthy lifestyle.
Scope of the results. The results of the study can serve as an information stage in the development of healthy lifestyle programs for students, as well as for the formation of approaches to the development of an evaluation scale for the effectiveness of such programs. -
2023 № 5 Medical and social problems of the prevalence of ENT diseases and the availability of otorhinolaryngological care to the population, including children (review of foreign literature)
An analysis of foreign scientific sources suggests that the prevalence of otorhinolaryngological diseases in the world is high and affects the increase in disability and mortality rates. The most common pediatric otorhinolaryngological disease worldwide is otitis media. Low availability of specialized otorhinolaryngologist care and socioeconomic disadvantage are associated with earlier, more frequent and severe ENT disease in children. The most vulnerable to otitis media leading to hearing loss are children of low socioeconomic status (even in developed countries) and indigenous children in all countries of the world. In low- and middle-income countries, pediatric
otorhinolaryngology faces challenges associated with a lack of infrastructure and equipment, a relatively small health care budget, a shortage of medical staff, and a lack of political will. In multicultural developed countries, the lack of understanding in medical institutions of the need to take into account ethno-cultural characteristics, as well as a decrease in confidence in medical institutions, creates constant barriers to access to medical services. -
2023 № 3 Lifestyles of students, including with disturbances in physical development during the COVID‑19 pandemic
The article deals with issues that characterize the lifestyle of students in the context of the COVID‑19 pandemic. A number of researchers found that during this period, cases of physical and mental health disorders, non-compliance with the norms of good nutrition, a significant decrease in physical activity, changes in the physical parameters of the body, weight gain, etc. became more frequent among students.
Materials and methods. An international methodology was applied to assess the structure of the students’ lifestyle – the Health-Promoting
Lifestyle Profile Questionnaire (HLPP-II). The methodology takes into account the characteristic features of 6 integral components (responsibility for health, physical activity, nutrition, spiritual growth, interpersonal relationships and stress management). For the purpose of comparative analysis, 505 students surveyed were divided into 3 groups depending on the body mass index: those with underweight, with normal body weight, and those with excess body weight.
Findings. The results obtained made it possible to establish that among those with a deficiency or excess of body weight compared with those with normal body weight, there were significantly more students with a low level of severity of all 6 considered components of the overall level of health. -
2023 № 3 Analysis of the morbidity of a separate medical university students before and during the pandemic of the new coronavirus infection COVID-19
The study of the health of modern students is an urgent problem that requires a comprehensive and comprehensive analysis. With the beginning of the COVID-19 coronarovirus pandemic, isolated works devoted to the study of the morbidity of students have been published.
In this regard, the study of the morbidity of medical students during the pandemic of a new coronavirus infection is of great practical interest.
Purpose. To analyze the morbidity and structure in medical university students before and during the pandemic of a new coronavirus infection COVID-19.
Materials and methods. Students of the Smolensk State Medical University of the Ministry of Health of the Russian Federation (SSMU) took part in a comprehensive study. Research bases -polyclinic, health center, serving university students. Sources of information in the study: reporting and accounting forms of a medical institution, a statistical coupon for registering final diagnoses and reporting documentation of healthcare organizations providing medical care to students. The analysis of morbidity was carried out according to the nomenclature, according to the “International Classification of Diseases, Injuries and Causes of Death X revision”.
Results. The analysis of the overall incidence showed its increase in the pre-pandemic period of the new coronavirus infection COVID-19, and in the first year of the pandemic - a significant decrease with a distinct increase in 2021. The level of primary morbidity in the first year of the pandemic decreased significantly, and in the second year it exceeded the values of primary morbidity, both before the pandemic and the first year of the pandemic. Analysis of the structure of morbidity by incidence, by classes of diseases showed that respiratory diseases were the most frequent among students both in the pre-pandemic and pandemic periods.
Conclusions. Thus, in the pre-pandemic period, there was an increase in both general and primary morbidity, as well as in all classes of diseases. Respiratory diseases were in the leading ranking place. In the first year of the pandemic, there was a decrease in the level of general, primary morbidity and the level of morbidity in almost all classes of diseases. In the second year of the pandemic, there was a significant increase in these indicators. -
2023 № 2 Epidemiology of tuberculosis in Russia and Rno-Alania during the COVID-19 pandemic
The study of the combination of diseases at the present stage of development of medicine is extremely relevant. Among the combined effect of various pathologies on humans and populations, two main concepts are distinguished: comorbidity (the combined effect of diseases on a patient or group), including the underlying and concomitant diseases, and syndemia (the combined effect of diseases at the population level).
P u r p o s e : to analyze the epidemiology of tuberculosis during the COVID‑19 pandemic to identify trends in Russia as a whole and in North Ossetia-Alania.
M e t h o d s : a theoretical analysis of the current research situation in Russia in relation to the tuberculosis and COVID‑19 syndemics was carried out. The data sources were annual forms of federal statistical observation.
R e s u l t s : Significant factors that slow down the dynamics of improving the epidemic situation for tuberculosis in Russia and North Ossetia-Alania are the reduction in the coverage of the population with preventive examinations for tuberculosis. In general, a clear syndemic between the epidemiology of TB and the COVID19 pandemic has not been identified both for Russia and according to the results of the analysis of statistics in RNO Alania. There are social trends to reduce the coverage of the population and belated primary treatment of patients with a general practitioner and phthisiatrician, as well as persons removed from the dispensary, so there is an increase in the proportion of severe forms of TB (with lung tissue destruction, fibrous-cavernous type).
C o n c l u s i o n s : The identified trends indicate a later appeal of patients during the pandemic and a decrease in population coverage in Russia and in the analysis of data for North Ossetia-Alania. The increase in the proportion of severe forms of tuberculosis is more likely to be associated with the above trends, and not with syndemic. Trends in the dynamics of TB indicators in Russia and North Ossetia-Alania are similar in terms of comparing negative or positive increases in indicators. -
2023 № 1 Medical and demographic indicators of the population older than working age in the conditions of pension reform in the Russian Federation
Purpose of the study. Based on the study of medical and demographic indicators and analysis of the incidence of the population, develop recommendations for the health protection of the population older than working age in the context of the transition to pension reform.
Materials and methods: sociological, statistical, direct observation. The materials of the Federal State Statistics Service and statistical materials of the TsNIIOIZ of the Ministry of Health of Russia for 2012–2021 were used.
Results. The mortality rate of the population older than working age in the Russian Federation (2020) amounted to 4408,1‰oo, the total population – 1460,2‰oo, in the federal districts of the Russian Federation the indicators fluctuated 1,2 times: from 3818,7‰oo in the North- Caucasian Federal District to 4638,6‰oo in the Volga Federal District, in the subjects of the Russian Federation the difference is 3 times. The indicator of primary morbidity of the studied contingent in the Russian Federation (2020) was 57041,4‰oo, in the Federal District the difference in indicators is 1,25 times, in the constituent entities of the Russian Federation – 3,9 times. The incidence of COVID‑19 in 2020 was 4373,9‰oo, in the Federal District the difference in indicators is 2,2 times, in the subjects of the Russian Federation it is large – 10,6 times, which allows us to conclude that the coding of COVID‑19 is ambiguous. Comparative analysis of the primary incidence of the study population by disease classes in 2019 and 2020 showed an increase in the indicator by 8,9% due to respiratory diseases by 40,8%, the incidence of COVID‑19 in 2020 was 4357,6‰oo. In all other classes, the indicators decreased as a result of a decrease in dispensary and preventive work. During the period of analysis in people older than working age, the increase in the primary morbidity rate is higher – 8,9% than in the total population – 5,7%, which indicates the need to strengthen dispensary and preventive work with the older population. The article gives recommendations on the health protection of the population older than working age. -
2023 № 1 Planning medical care for patients with cancer in the constituent entities of the Russian Federation.
National project “Fight against oncological diseases 2019 - 2024” implemented for the fourth year. During this time, experience has been gained in planning the volume of medical care, including diagnostic tests, and financial support in the system of compulsory medical insurance, but there is no systematic analysis of planning problems. The purpose of this study was to study the planning by the subjects of the volume of medical care and their implementation of the target indicators of the territorial programs of state guarantees of free medical care (TPGG) and to identify planning problems. We analyzed the territorial programs of state guarantees of some subjects of the Russian Federation. Also, from the territorial CHI Funds (TFOMS) we received information on the performance of TPSG indicators: the
volume of care in round-the-clock and day hospitals, planned and actually performed molecular genetic studies and cases of positron emission tomography combined with computed tomography in 2021 and the first half of 2022 of the year. We found significant problems, some of which have causes at the federal level, others are purely regional in nature, which lead to significant differences in planning the volume of medical care between the subjects of the Russian Federation. Conclusion. Planning the volume of medical care in the field of “Oncology” varies significantly between the subjects of the Russian Federation and has systemic difficulties, control over the effective use of funds is insufficient. We consider it necessary when planning medical care for the oncology profile in the Program of State Guarantees of
Free Medical Care to take into account the standardized incidence rate per 100,000 population, and not the number of insured persons in the subject. -
2023 № 1 Bronchitis in children’s populations of different countries, risk factors
The issues of etiology, clinical presentation, distribution, diagnosis and treatment of bronchitis, as one of the most common respiratory diseases among children, are of considerable research interest. Risk factors for bronchitis are considered meteorological indicators (wind speed and direction, anomalies in relative humidity and atmospheric pressure, a decrease or increase in temperature), environmental pollution (tobacco smoke, NO2 and PM10), immune dysfunctions, preterm birth, exclusive breastfeeding for ≤ 4 months of life. Currently, a significant place in the research literature is occupied by the issues of acute, protracted bacterial and plastic bronchitis in children. Acute bronchitis is mainly caused by a viral infection, mainly rhinovirus, enterovirus, influenza A and B viruses, parainfluenza, coronavirus, human metapneumovirus and respiratory syncytial virus, with bacteria detected in 1–10% of cases. Protracted bacterial bronchitis, isolated as a clinical diagnosis since 2006, can occur in up to 88,5% of cases in children with chronic wet cough, wheezing and airway deformities, more often in children under 6 years of age and males. Prolonged bacterial bronchitis is mainly caused by the bacteria Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis. It is believed that recurrent bronchitis (>3 episodes/year) and the presence of H. influenzae infection in the lower respiratory tract may be significant risk factors for bronchiectasis Plastic bronchitis, a rare disease, in the
pediatric population is associated with cardiothoracic surgery (Fontaine operation), infections (viruses influenza, Mycoplasma pneumoniae, tuberculosis, adenoviruses, in particular serotype 7), inflammatory and allergic diseases, acute chest syndrome and iatrogenic processes. -
2023 № 1 Socio-hygienic and clinical-microbiological features of the formation of reproductive health disorders in adolescent girls
Studies show that inflammatory diseases of the small pelvis and inflammatory diseases of the external genital organs are risk factors for the formation of reproductive health disorders in adolescent girls, the reason for seeking advice and treatment in outpatient and inpatient medical organizations. It is generally believed that pelvic inflammatory disease, as a consequence of the activity of a polymicrobial infection, usually occurs in sexually active women and is rare in young women and adolescent girls who are not sexually active. However, worldwide the prevalence of pelvic inflammatory disease remains quite high among children and adolescent girls of prepubertal and sexually inactive age. In contrast, inflammatory gynecological diseases of the external genital organs are considered a common pathology in girls of early and prepubertal age, however, studies show that they are common among adolescent girls due to the high prevalence
of risk factors. Early diagnosis and treatment of pelvic inflammatory disease (PID) in adolescent girls is essential to ensure fertility and reproductive health in this population. -
2022 № 10 Problems of medical support for persons over working age (by the example of the Republic of Tatarstan)
Currently, most countries are showing a demographic trend characterized by an increase in the number of older people. In Russia, there is also a significant aging of the population, in connection with which, the number of people older than working age seeking medical care is growing every year. At the same time, the need is growing not only for treatment and rehabilitation, but also for the prevention of diseases, the implementation of active longevity programs. All this emphasizes the relevance and necessity of high-quality and sufficient medical support for this category of people.
Purpose: to study the features of medical support for people older than working age on the example of the Republic of Tatarstan.
Materials and methods: the data of official statistics, including those of the Ministry of Health of the Republic of Tatarstan, were used in the work. Analytical, statistical, mathematical research methods were used.
Findings: To create optimal resource provision in the provision of medical care to people older than working age, it is necessary to: introduce new indicators of the state of health, increase the number of geriatricians, increase the number of geriatric beds, not reduce therapeutic beds, constantly increase the coverage of preventive medical examinations, medical examinations of people older than working age age, based on their share in the population structure (at least 25%). -
2022 № 10 Mathematical prediction of the risks of iron deficiency in women
Purpose. Based on the study of medico-social, medico-biological and psychological factors, to assess the risks of iron deficiency in women. The results obtained will be used to develop a relevant program for the prevention of iron deficiency anemia and latent iron deficiency in primary health care.
Materials and methods. The medical and social study was conducted on the basis of the city polyclinics of Kazan, the samples included two groups of women: 394 patients with laboratory-confirmed iron deficiency, including its clinical manifestations, and 373 women with a confirmed absence of iron deficiency and without probable complaints. The following methods were used in the study: bibliographic, socio-hygienic, psychological testing, sociological, information-analytical, mathematical-statistical, organizational experiment.
Results. New data have been established on the factors affecting the volume of tissue iron stores in women: statistically significant associations of serum ferritin with sleep quality parameters and carbohydrate intake. The risks of iron deficiency anemia and latent iron deficiency were assessed, and subranges for individual risk groups were calculated.
Findings. Statistically significant associations were found in the ferritin-total protein model with late bedtime (p <0,001), discrete sleep patterns (p <0,001), situational anxiety (p <0,001), and daily sugar intake (p = 0,021). According to mathematical forecasting, the greatest influence on the development of IDA in women is “going to bed” (R=2,1). Women who go to bed after midnight and from 23.00 to midnight are at risk of iron deficiency anemia, the risk of which is 2 times higher than in women who fall asleep before 23.00. The probability of latent iron deficiency in women with a high level of personal and situational anxiety is 28–29 times higher than in women with a low level of anxiety (R=29,254 and R=28, respectively). -
2022 № 10 Assessment of the economic burden of psoriasis in the republic of Bashkortostan
Psoriasis is one of the most common chronic dermatoses, leading to disability of patients. The damage from it is comparable to the damage from atrial fibrillation, lung cancer, breast cancer.
P u r p o s e of our study was to determine the economic burden of psoriasis in the Republic of Bashkortostan, depending on the volume of costs for different treatment options.
M a t e r i a l s a n d m e t h o d s . The paper calculates the economic burden of psoriasis in the Republic of Bashkortostan based on official data from the Medical Information and Analytical Center of the Republic of Belarus, the Territorial Compulsory Medical Insurance Fund of the Republic of Belarus and Bashkortostanstat for the period 2020-2021.
R e s u l t s . There is increase in the number of patients with psoriasis in the Republic of Bashkortostan for the period 2012-2021. The total economic burden of psoriasis in the Republic of Bashkortostan is 896970909,00 rubles in year (66055,7 rubles per patient), including: for all types of treatment, taking into account the funds of the patients themselves, 559028692,5 rubles are spent, for temporary disability benefits 300293897,6 rubles, disability benefits 37648318,9 rubles. The largest proportion of patients regularly treated for psoriasis are patients receiving therapy both in a hospital and in a polyclinic (42,1%). The allocated volumes of high-tech medical care, as well as genetically engineered biological therapy in the Republic of Bashkortostan are insufficient to provide all patients in need with these types of assistance. One third of patients with psoriasis (33,6%) do not seek treatment from dermatovenereologists.
C o n c l u s i o n . The results obtained indicate the need for further detailed study of the issue of economic costs associated with the prevalence of psoriasis in the Republic of Bashkortostan, the development of measures to reduce the incidence of the population, risk factors and relevant policy documents for the resource provision of medical care for patients. The medical, social and economic efficiency of the measures will be expressed by improving the quality of life of patients, reducing the economic damage from temporary disability and disability. -
2022 № 10 Comparative assessment of adherence to vaccination of young mothers and medical university students
Vaccination is a proven tool for fighting infectious diseases. With the development of the pandemic, the relevance of vaccination prevention has significantly increased, and therefore the importance of considering aspects of vaccination among various population groups has increased. Of particular importance is the commitment to vaccination of medical university students, as future doctors on the one hand, and young mothers on the other.
P u r p o s e – identification of the peculiarities of adherence to vaccination of students of a separate medical university and young mothers of a certain territory to optimize the popularization of vaccination prevention.
M a t e r i a l s a n d m e t h o d s . A comparative study of vaccination adherence of 167 medical university students (average age 22,3±0,79 years) and 200 mothers aged 19 to 30 years (average age 23,5±5,1 years) living in Smolensk was planned and conducted. In the course of the study, statistical, analytical methods, and open online questionnaires were used.
R e s a l t s . The analysis of the results of the survey of young mothers and medical students indicates a generally positive attitude towards vaccination, the importance of which is understood by more than half of the respondents. Respondents of both groups are actively interested in the topic of vaccination prevention and would like to receive more information on this issue. The main source of information about vaccination in both young mothers and medical students are medical professionals. The majority of respondents of both sexes will vaccinate their children within the framework of the National Calendar of Preventive Vaccinations.
F i n d i n g s . It is necessary to strengthen the formation of commitment to vaccine prevention among medical students and young mothers.
This can be done by making changes in the educational structure; conducting webinars, seminars, conferences on immunoprophylaxis; development of informational materials for the population on vaccine prevention in the form of models, posters with the participation of students. It will be advisable to involve volunteers – medical students to speak to parents and peers on vaccination, as well as strengthening health education work among the population and talking to parents about the possible consequences of lack of vaccination. -
2022 № 9 Methodological foundations of forecasting the spread of diseases in the world (review)
In modern conditions, the prediction of the morbidity of the population is becoming one of the most urgent tasks of public health worldwide. For state and international health services, with the help of forecasting the possible incidence and prevalence of various diseases in the general population, it becomes necessary to improve the system of providing specialized care due to the possibility of an updated calculation of the necessary resources.
Purpose of the study is to analyze the methodological basis for predicting the morbidity of the population based on the study and generalization of literary sources.
Materials and methods. The materials for the analysis were scientific publications on the issues of forecasting and modeling of morbidity in various subgroups of the population and territories of the Russian Federation and other countries. In the course of the research, such methods as comparative analysis, study and generalization of experience, bibliographic were used.
Results. Currently, there are a number of studies devoted to disease prediction, and the number of methodological approaches to predicting possible changes in the epidemiological situation in various territories is growing. The study provides an overview of existing methodological approaches to predicting the morbidity of the population in Russia and in the world community.
Findings. Thus, the analysis of the experience of predicting morbidity made it possible to determine the features of the use of certain mixed methods of forecasting different classes, groups and types of diseases, especially when identifying new viruses and infectious diseases. -
2022 № 9 Health related quality of life as a predictor of the transfer of patients with COVID‑19 to the intensive care unit
Understanding the results of self-assessment of health-related quality of life in patients with COVID‑19 is an important part of the full and objective picture of the medical condition on the first day of hospitalization when making decisions to start early intensive care in the resuscitation and intensive care unit.
H y p o t h e s i s : the values of health-related quality of life indicators in patients with COVID‑19 on the first day of hospitalization are interrelated with the fact of their stay in the resuscitation and intensive care unit.
P u r p o s e : a retrospective study of the relationship of health-related quality of life in patients with COVID‑19 on the first day of hospitalization and the necessity of treatment in the resuscitation and intensive care unit.
M a t e r i a l s a n d m e t h o d s . The study was conducted on the basis of the “Kommunarka” Moscow Multidisciplinary Clinical Center of the Moscow City Health Department from March 2021 to April 2022. Data collection was carried out using a paper- and-pencil Russian version of the EQ‑5D‑5L questionnaire (Tracking Number: 41183). Additional patient data was extracted from electronic medical records. Two types of EQ‑5D‑5L questionnaire results were evaluated: the EQ index and the visual-analogEQ scale. All calculations of the regression model were carried out using the language R4.2.1 in the software environment RStudio 2022.02.3 Build 492.
F i n d i n g s . This study is the first work where health-related quality of life indicators measured during the first 24 hours of hospitalization in order to predict the transfer of patients with COVID‑19 to the intensive care unit. The best results of self-assessment of their medical condition in the course of hospitalization were revealed in those patients who did not require further treatment in the intensive care unit. The worst results of self-assessment of their medical condition were revealed in lethal patients hospitalized in the intensive care unit on the first day. Two logistic regression models demonstrated a significant relationship of the EQ Index and the Mobility domain with the probability of transferring patients to the intensive care unit. The results obtained prove that subjective indicators of health-related quality of life reflecting the perception of one’s illness “here and now” along with objective clinical indicators are independent predictors of the transfer of patients with COVID‑19 to the resuscitation and intensive care unit.
C o n c l u s i o n . Health-related quality of life indicators (EQ Index and MO) can be used to predict the early use of preventive measures to prevent the deterioration of patients’ condition and reduce the load on the intensive care unit -
2022 № 9 The role of risk factors in childhood on the formation of chronic obstructive pulmonary disease
An analysis of literature on COPD in children has shown that COPD arises from an accelerated decline in lung function, an inability to achieve normal lung function after childhood, or a combination of the two. Risk factors for the development of COPD are considered negative environmental influences; maternal smoking, intrauterine development disorders, prematurity, low birth weight, bronchopulmonary dysplasia, as well as frequent or severe respiratory infections in childhood (especially respiratory syncytial virus and rhinovirus) that prevent the full growth and development of the lungs; asthma in childhood; early allergic sensitization and/or a rare genetic disorder (alpha‑1 antitrypsin deficiency), childhood chronic cough, parental history of respiratory disease, and low educational attainment. Particularly vulnerable are children from socio-economically low strata of the population, in particular,
from among the indigenous population of multi-ethnic countries. In low- and middle-income countries, diagnosing COPD is difficult, and the disease may go undiagnosed. Bronchial asthma in childhood can be considered as an independent risk factor for COPD in adulthood. At the same time, the asthma-COPD overlap syndrome is widespread, the risk of which is especially high among individuals with persistent and severe childhood asthma, which is highly dependent on genetics. Targeted programs are needed to reduce the risk of adverse pulmonary outcomes in disadvantaged children, as well as the integration of specialized outreach services into primary health care. The WHO COPD core package includes protocols for assessing, diagnosing and managing COPD, as well as modules on healthy lifestyles, including smoking cessation and self-help, and development of rehabilitation services. -
2022 № 8 The issue of age-related characteristics of the prevalence of diabetes mellitus among the population of various countries
Without interventions to halt the rise in diabetes, it is believed that by 2045 there will be at least 629 million people living with diabetes in the world. Currently, four out of five people with diabetes, approximately 80% of the world’s 463 million, live in lowand middle-income countries, and the incidence of diabetes is increasing in poorer, marginalized, socioeconomically vulnerable and indigenous communities. The prevalence of type 2 diabetes with onset in youth, defined as diabetes diagnosed before the age of 25, is increasing worldwide. It should be noted that type 2 diabetes, which occurs at a young age, most often manifests itself in the second decade of life. There are about 652 thousand children with type 2 diabetes in the world. It is estimated that there will be around 41,600 new cases of diagnosed type 2 diabetes in children and adolescents worldwide in 2021. Along with the increase in the prevalence of diabetes among children and adolescents, there is an increase in the incidence of pre-diabetes preceding the development of type 2 diabetes. They found an 8% risk of progression from pre-diabetes to type 2 diabetes over a 3-year period, confirming the importance of interventions to reduce obesity, pre-diabetes, and insulin resistance.
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2022 № 8 Prediction of disease outcomes in patients with COVID-19 based on the EQ 5D 5L questionnaire
In order to provide effective medical care to patients with COVID-19 in hospitals, the disease outcome prognosis is of
considerable importance. The authors of the study suggested a relationship between health-related quality of life indicators and the outcomes of the disease of patients hospitalized because of COVID-19.
P u r p o s e . Retrospective study of the relationship between health-related quality of life in patients with COVID-19 on the first day of hospitalization with the outcomes of the disease in a hospital and at the stages of rehabilitation up to 180 days following the discharge to predict outcomes at the early stages of the disease.
M a t e r i a l s a n d m e t h o d s . The study was conducted at the “Kommunarka” Moscow Multidisciplinary Clinical Center of the Moscow City Health Department from March 2021 to April 2022. Data collection was carried out using a paper-and-pencil Russian version of the EQ-5D-5L questionnaire (Tracking Number: 41183), on the first day of admission of patients to the hospital. Additional patient data was extracted from electronic health records. Two types of EQ-5D-5L questionnaire results were evaluated: Index EQ and the Visual Analog scale (VAS) EQ. All calculations of the regression model were carried out using the R 4.2.1 language in the RStudio 2022.02.3 Build 492 software environment.
F i n d i n g s . In the obtained logistic regression model, the extremely high statistical significance of the variable “Index EQ” (p<0.01) was demonstrated, the greater the value of the variable “Index EQ” is, the less the probability of a fatal outcome is.
At the same time, there is no statistically significant relationship between the variable VAS EQ under study and the probability of a fatal outcome.
C o n c l u s i o n s . An extremely significant relationship between the calculated health-related quality of life index, Index EQ, and outcomes of COVID-19 when patients were admitted to the hospital was revealed, which makes it possible to use it as a predictor of disease outcomes at early stages. No significant relationship between the VAS EQ and the outcomes of the disease in patients with COVID-19 on the first day of hospitalization was revealed, which makes it impossible to use it as a predictor of disease outcomes at the early stages. Application of the health-related quality of life index, Index EQ can be used to make medical decisions in order to early predict tactics of patient management in hospital treatment and rehabilitation. -
2022 № 8 Population and birth rates in assessing dynamic changes in the reproductive potential of the region
The article analyzes the dynamic changes in the main indicators of the reproductive potential of the region, such as the
number of female and male population of the region (on the example of the Republic of Dagestan), the structure of women by age groups and changes in the number of women of reproductive age, birth rates. The theoretical material for the study was legal documents and statistical collections, literary sources, as well as materials of statistical analysis of the demographic situation in the regions; in the course of the analysis, the following methods were used: study and generalization of experience, analytical, statistical.
M a t e r i a l s a n d m e t h o d s : bibliographic, sociological, statistical and analytical methods.
F i n d i n g s . The results of the study showed that the number of women in the age groups of 15–19 years and 20–24 years has noticeably decreased in the republic, in recent years the number of women in the age group of 25–29 years has been declining (after their stable growth in previous years), and negative changes in the structure of the number of women of young childbearing age may cause a decrease in the birth rate in the coming years, despite the still high level of large families. -
2022 № 7 On the issue of the current state of the medical and demographic situation in Russia
At the present stage in Russia, the main strategic initiatives aimed at improving medical and demographic processes are set out in a number of regulatory documents presented in the form of national projects, concepts, strategies and other federal projects, while special attention is required to study and monitor these indicators of public health of the population.
Purpose of the study is analysis of the medical and demographic situation in Russia and in individual subjects in recent years, making proposals to improve the processes of fertility and mortality, migration growth.
Materials and methods. Scientific publications, official statistical data and analytical materials of Rosstat, data from the
statistical collection of the SFO were used as research materials. Statistical data processing was carried out using SPSS, Excel‑2007 packages. The main research methods were: the study and generalization of experience, information-analytical, statistical, bibliographic.
Results. The analysis of the dynamics of indicators of the demographic situation in the Russian Federation determined a low degree of compliance with the priorities of the state policy; there was a negative dynamics and a discrepancy between the actual value of the planned target indicators, therefore, in order to eliminate the existing problems, it is necessary to take into account the specifics of individual territories when setting and formulating strategic directions and initiatives on this problem.
Findings. The results of the study indicate the need for constant monitoring of the main demographic indicators, considering certain directions and the course of the state policy pursued in this direction. -
2022 № 7 Analysis of morbidity and staffing of the population of rural areas in the Russian Federation
Rural health care is the most important socio-economic resource in the system of the agrarian economy.
Purpose of the study. Based on medical and demographic indicators and analysis of morbidity and staffing of the rural population, develop proposals for improving the organization of medical care for rural residents.
M a t e r i a l s a n d m e t h o d s : analytical, statistical, direct observation. The article used the forms of federal statistical observation of the Ministry of Health of the Russian Federation.
R e s u l t s . The mortality rate of the rural population over the 20 years of analysis for all the years has been and remains higher than that of the urban population. In 2020, there was a sharp increase in the mortality of the population: urban – from 11,9 to 14,3‰, rural – from 13,3 to 15,4‰, which is associated with the COVID‑19 pandemic. The indicators of the general and newly diagnosed morbidity of the rural population are lower than those of the urban population, which is associated with the low availability of medical care to the rural population.
The ranking of indicators of the general incidence of the rural population in the federal districts of the Russian Federation (2020) showed that the difference in indicators was 1,5 times. The highest indicator was noted in the Volga Federal District – 142220,6‰00, the lowest in the Far Eastern Federal District – 96922,8‰00. In the subjects of the Russian Federation, the difference in indicators is 8 times. Lower rates of primary morbidity in the rural population than in the urban population were noted for all classes of diseases. The incidence of COVID‑19 among rural residents was 2151,9‰00, lower than in urban areas – 4539,5‰00, in the Russian Federation the figure was 3384,5‰00. In 2020, the primary morbidity rate of the rural population decreased for all classes of diseases, except for respiratory diseases. In dynamics (2014–2020), the provision of medical organizations located in rural areas increased with doctors from 12,1 to 14,0‰0, with nurses from 44,4 to 50,3‰0, the number of physical EMS persons decreased by 14,8%, paramedics – by 11,6%, the number of FAPs and AFs decreased by 8,9%. The analysis shows that the Decree of the Government of the Russian Federation dated 02.02.2015 No. 151-r “Target indicators of the strategy for sustainable development of rural areas of the Russian Federation for the period up to 2030” is not being implemented.
C o n c l u s i o n . Proposals for providing medical care to the population of rural areas are presented -
2022 № 7 The disease burden of atopic dermatitis in current conditions
The prevalence and increase in morbidity of the atopic dermatitis make possible to consider it to become actual and relevant in nearest future. The pilot study analyzed using the Delphi method allowed identifying the most significant areas for further detailed research and development of programs reducing the disease burden of atopic dermatitis in the country. The study showed that the Cumulative Life Course Impairment associated with this disease is mediated by its systemic nature and a complex of concomitant diseases. The social burden of the disease is primarily associated with missed opportunities of patients even after the onset of spontaneous remission due to education and socialization issues from the period of schooling. Almost all adult patients report a decrease in the quality of life and experiencing problems with communication and sports. The economic burden of the disease is associated with household spending on medicines and a decrease in income as a result of changing or losing work, primarily in families with sick children in addition to healthcare system expenditures. The COVID‑19 pandemic has led to a decrease in the volume of medical care for atopic dermatitis adult patients and also there is a possibility of developing previously unknown complications in patients with atopic dermatitis.
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2022 № 7 Data-based management in imaging: evaluation of the performance of a unified radiological information service model
The development and availability of information technologies covers all spheres of society, providing ever newer and more advanced means of automating processes and structuring data, primarily in order to improve management efficiency.
Radiation diagnostics, due to its clinical significance, is one of the key areas of modern healthcare. At the same time, it is distinguished by an extremely high degree of digitalization, which creates extensive opportunities for the development and improvement of organizational and managerial aspects. An analytical study was carried out on the principles of a systematic approach, consisting of three stages.
First stage. The main phases and indicators of the development of a single digital circuit for radiodiagnosis in Moscow are characterized: the dynamics of the integration of diagnostic equipment, the structure of medical organizations, the rate of accumulation of the results of radiological examinations by modality.
Second phase. The analysis of the influence of a single digital circuit of radiodiagnosis on the level of informatization of medical organizations and informatization of the health care system of a constituent entity of the Russian Federation was carried out, its compliance with the requirements of the Ministry of Health of Russia was assessed.
Third stage. The analysis of the influence of a single digital circuit of radiodiagnosis on the level of digital maturity of the health care system of a constituent entity of the Russian Federation was carried out.
The practical implementation of the model of a single digital circuit for radiation diagnostics of an administrative-territorial unit was carried out in the period 2015–2020 in Moscow.
The Unified Radiological Information Service (UIS) of Moscow was created – an information system in the field of healthcare that combines the workplaces of radiologists, radiologists and diagnostic equipment, accumulates information about each study or a series of studies conducted on devices connected to it, is equipped with additional tools for solving analytical, managerial and organizational tasks.
The analysis of the significance of ERIS EMIAS as an implemented single digital circuit for radiodiagnosis of a subject of the Russian Federation was carried out.
The development of URIS EMIAS ensured a steady increase in the level of informatization coverage of medical organizations that have radiation diagnostics units in their composition.