Bulletin of Semashko National Research Institute of Public Health

One of the priority projects of the State Program of the Russian Federation “Development of Health Care” until 2025 is “Improving the organization of medical care through the introduction of information technology”. A survey of 65 constituent entities of the Russian Federation revealed that only 14 subjects installed software for automated coding of deaths according to the ICD, 51 subjects did not implement automated coding, and work was planned in 7 subjects. Thus, it is necessary to develop a modern technological plan that complies with the regulatory documents of the Ministry of Health of the Russian Federation, an automatic coding system according to ICD-10, version 2014-2016.

Health care reform aimed at increasing the availability of medical services, reducing morbidity, disability and mortality of the ablebodied population in the state is impossible without the implementation of epidemiological monitoring of occupational pathology, which is based on statistical accounting and analysis of data on morbidity and mortality. Therefore, the unification of the system for recording and processing statistical information on morbidity and mortality is the main condition for improving the organizational structure, managing the health care system, monitoring the effectiveness of primary prevention, etc. It was the adaptation of the WHO recommended system for recording and recording data in the field of occupational health to the characteristics of medical statistics and occupational pathology in Russia that became the goal of this study. The study analyzed the International Classification of Occupational Diseases and the “List of Occupational Diseases” in force in the Russian Federation based on Order No. 417n dated April 27, 2012. The application of the ICD-10 codes in them was studied. The possibilities of adapting professional pathology codes in accordance with ICD-10 and WHO recommendations are analyzed. The classification of occupational diseases contains both categories determined according to etiological agents, and categories defined according to a medical diagnosis. As a result, cases of the same disease can fall into several categories, and there are no unified diagnostic criteria, statistical coding systems and classification of occupational diseases. All this greatly complicates the medical-statistical accounting and monitoring of this group of diseases. To overcome these shortcomings, create and officially adopt a separate (specialized) “Statistical Classification of Occupational Diseases”, it is necessary to use the main and additional sections provided for by the ICD- The unification of the system of statistical coding of occupational diseases is an urgent task that requires implementation in medical statistics, which will significantly improve the accounting for this group of diseases, conduct longterm monitoring of the working conditions of people, the effectiveness of primary prevention of occupational pathology. The use of a unified system of statistical coding of pathology will also make it possible to objectively assess the levels of occupational morbidity both at the national and international levels, conduct a standardized analysis of the morbidity of workers by age, sex, medical, social and geographical groups, and therefore significantly improve the management of the healthcare system in the Russian Federation and ensure an effective system for the prevention of occupational diseases.

The purpose of the study: analysis of high-tech medical care included in the basic program of compulsory health insurance. Since 2014, high-tech medical care has been included in the basic program of CHI (hereinafter - VMP CHI). Payment of the VMP at the expense of the CHI has been carried out for almost four years. All the necessary legal acts on this issue have been adopted in full. Materials of the Department of health of the city of Moscow, statistical data on activity of the medical organizations rendering VMP OMS, reports of the Moscow city Fund of compulsory medical insurance, data of information and analytical system of the Ministry of health of the Russian Federation "Subsystem of monitoring of implementation of hi-tech medical care" are used for the analysis [1]. The article presents the main results of this practice in Moscow, presents the current issues of financial support and provision of VMP CHI in modern conditions.

The study of the structure and organization of the system of medical rehabilitation existing in the Zabaykalsky Krai is necessary for the development and implementation of modern organizational technologies for medical rehabilitation in the context of regional health care. The article analyzes the main indicators characterizing the stages of medical rehabilitation in the area of traumatology and orthopedics. The influence of medical and organizational factors on the level of hospitalization and the number of outpatient visits is studied. The analysis of the main indicators characterizing the state of human resources of the medical rehabilitation system of patients with musculoskeletal system diseases in the Zabaykalsky Krai is carried out.

The article presents the results of the analysis of the dynamics of the number and urbanization of the Kemerovo region in comparison with the all-Russian demographic trends. The features of the demographic processes of the Kemerovo region (KO) were revealed: the maximum population of Russia and KO was recorded in 1989-1991, but the growth rate over the previous 50-year period in the region was 49.9% higher than the all-Russian one. The reduction in the total population, including the urban one, which began in Russia at the beginning of the 1990s, is proceeding more rapidly in the Kemerovo Region. Positive dynamics of population growth in Russia, noted in the first decade of the 2000s, is absent in KOs - the population of the region has been declining annually since the beginning of the 90s. Against the background of a decrease in the absolute and relative population of the region, its level of urbanization remains high and has a tendency to increase (2005 - 84.4%, 2019 - 86.0%). Kuzbass became an urbanized region on the eve of World War II (1939 - 55%), Russia - in 1959 (52.1%). Kemerovo region is still the most urbanized region in the Siberian Federal District. According to the urban population for the period 1990-2019. linear trend equations are constructed, indicating a further decrease in the urban population of the region while maintaining a high level of urbanization (2030 - 84.5%).

The article deals with the key issues of organization and deployment in Russia of a patient-oriented health care model. The current state of Russia is characterized by a transition period to a patient- oriented model of health care, as evidenced by the existence of a legal framework. As a result of the research, some components of the patient-oriented model were also identified, for example, the Unified State Health Information System. However, for the complete transformation, it is necessary to pay special attention to the seven elements mentioned in this article.

The aim of the study is to analyze the degree of influence of family environment on morbidity in older age groups. Morbidity data were obtained by copying data from medical records of 967 people. The sample was formed on the basis of random selection. The General population represented the population attached to the city polyclinics of Moscow. The median age was 71.08±1.3 years. The study shows that family environment can be considered as social determinants of health of the population in older age groups, as confirmed by analysis of such features as: the fact of living together, subjective psychological climate in the family, the presence of the family Pets. The study shows that when living together with other family members, the incidence of chronic noncommunicable diseases is lower than when living alone, both men and women of the appropriate age, the data Obtained can be used in the formation of a health-saving environment that allows to prolong active longevity and preserve the health potential of the population of older age groups.

The aim of the study is to analyze the degree of influence of the level of education on the incidence and intensity of consumption of health services in older age groups on the basis of data on the incidence and intensity of consumption of health services in the population aged 60 years. A total of 967 people were studied. The analysis of the influence of education on morbidity and intensity of consumption of health services in different age and sex groups showed that regardless of gender, there is a trend to increase the level of morbidity with increasing age, but the rate of increase in morbidity is higher in men, especially in the age group of 66-70 years, and in women in older age groups. The level of education can be considered as a positive determinant of health in older age groups in men, as in men, a higher level of education is combined with lower values of the incidence of chronic pathology in older age groups, while in women its significance is questionable. There were no significant differences in the proportion of requests for medical care of persons with different levels of education. The proportion of applicants increased with increasing age, which was typical for both men and women, regardless of their level of education. The weighted average frequency of acute diseases did not depend on gender and age of the person, higher frequency of acute diseases were registered in women. Survey data on the presence or absence of chronic diseases, as well as the cost of buying drugs is not appropriate to use in the analysis of the health of older age groups.