Bulletin of Semashko National Research Institute of Public Health

Currently, the healthcare system is faced with the task to implement clinical guidelines into clinical practice, which requires an assessment of needs for resource support for the provision of medical care. Starting from 2019, standards of medical care are being developed based on clinical guidelines. The study assessed the possibility of planning the resource support for the provision of medical care for cancer diseases according to the standards of medical care developed on the basis of clinical guidelines. As a result, it was shown that the standards of medical care approved by the order of the Ministry of Health of Russia make it possible to assess the need for medicines and the number of cots. Wherein the digital prototype of medical care standards allows for a more detailed assessment and in terms of the conditions for providing medical care, types and methods of antitumor treatment, as well as additionally assessing the need for medical care and medical personnel. So currently the standards of medical care developed on the basis of the clinical guidelines can be considered as a tool for managing the organization of cancer care.

The State is currently implementing programs aimed at improving the scheme of providing medical rehabilitation services to patients. The article analyzes the changes in legislation adopted in 2023. The assessment of changes in the structure was carried out on the example of the work of the Federal State Budgetary Institution Reshma medical center of the FMBA of Russia. For this purpose, a retrospective analysis of the medical histories of patients treated in a round-the-clock and day hospital in 2022 and 2023, as well as patients treated on an outpatient basis in 2023, was carried out. As a result of the conducted research, a tendency has been established to expand the possibilities for receiving and managing patients more difficult to curate (according to the rehabilitation routing scale equal to 5 points), as well as an increase in the coverage of patients hospitalized from the second to the third stage as part of a day hospital or outpatient rehabilitation.

The study evaluates the costs of medical treatment of patients suffering from narcological disorders in a 24-hour hospital with various diagnoses according to ICD — 10. The aim of the study is to assess some characteristics of the costs of the drug treatment used for patients with various drug-related diseases when providing them with medical care in inpatient settings, taking into account the variability of costs, the degree of their compliance with clinical recommendations, and the average cost. Materials and methods. The calculation of the characteristics of drug costs in four groups of patients with the most common diagnoses according to the profile «narcology» was made. 200 medical records of an inpatient patient — case histories (form No. 003/y) of patients who underwent treatment in the hospital of the state budgetary healthcare Institution (GBUZ) «Samara Regional Clinical Narcological Dispensary» in 2022 were analyzed. The cost variation coefficient was calculated, and the average cost values for medicines (in rubles) were compared. It is also determined what proportion of the cost of medicines falls on the drugs recommended by clinical protocols, or groups of drugs. Analytical and statistical research methods were used. Results. The average cost of medical treatment per hospitalization for all diagnoses amounted to 1969.1±157.5 rubles. with the highest costs for the treatment of withdrawal caused by opioid use (2189.7 ± 176.4 rubles) and the lowest costs for the treatment of uncomplicated withdrawal caused by alcohol use (1484.6 ±145.7 rubles). In general, for all groups of patients, the share of costs for the groups of medicines recommended in the clinical recommendations is 58.3%, which is quite low. High values of the coefficient of variation of drug costs in the studied groups were obtained from 33.2% for opioid dependence syndrome to 56.9% in the group of patients with alcohol dependence syndrome undergoing aversive treatment. The cost of medicines for the treatment of patients diagnosed with uncomplicated withdrawal caused by alcohol consumption had a significant difference from the cost of drug treatment of patients of other groups. Conclusion. Despite the high rates of the coefficient of variation of costs and the presence of statistically significant differences in the average cost of inpatient treatment of some groups of patients, it is premature to draw conclusions about the need to increase the number of clinical and statistical groups (CSG) in the profile of «narcology» with budgetary financing of the system, based on the difference in the cost of medicines. It is correct to compare the average cost values in groups with different diagnoses with comparably high levels of spending on medicines included in clinical recommendations.

Digitalization extends to all spheres of public life and branches of the functioning of the state, including the healthcare sector, including primary health care. At the same time, the effectiveness of the introduction of innovative technologies directly depends on the level of their use and the general perception of the population. The purpose of this study is to analyze the opinions of patients about the process of digitalization of medical organizations providing primary health care. The materials and methods include the analysis of scientific articles and information from Internet sources relevant to the declared topic, as well as conducting a questionnaire. Data collection was carried out in the period from June to September 2023 and covered 48 subjects of Russia. The survey was conducted using the online service «Yandex.Forms» and included 2437 patients of medical organizations. This article presents an analysis of the results on eight key questions of the questionnaire, which were selected to assess the opinion of patients regarding the process of digitalization of primary health care. As a result of the study, it was revealed that the majority of respondents have a positive attitude to digitalization in medical organizations providing primary health care, but additional improvements are required, such as greater participation of medical personnel and patients in digital technologies, specialized portals, expansion of telemedicine and innovative services.

Understanding eating behaviors and the factors that affect them is important for the prevention and treatment of overweight and obesity. Therefore, the aim of this study was to determine the relationship of subscales of eating behaviors with age, body mass index, psychological distress and social support among university students in Yakutsk, Republic of Sakha (Yakutia). An online cross-sectional survey was conducted among undergraduate students of North-Eastern Federal University named after M.K.Ammosov from October 1 to November 30, 2022. An independent sample t-test and Pearson's correlation coefficient were used for analysis of the data. The p-value cutoff for statistical significance was 0.05. A total of 384 study participants were included in the analysis. Among the study participants, 242 (63%) were females with a mean age of 20.93+2.1 years. The majority of study participants (69%) had external eating behavior, 67.4% had emotional eating behavior and 43.8% had restrictive eating behavior. The three kinds of eating behaviors namely emotional eating behavior, restrictive eating behavior and external eating behavior were positively correlated each other. The eating behaviors were also correlated with psychological distress and body mass index. Therefore, to better understand the relationship between eating behaviors and their causal factors, a properly designed longitudinal study is required.

An integrative approach and application of project management technologies are the basis of the National Suicide Prevention Strategies. World experience confirms the effectiveness of strategies and justifies a regular repetition of their life cycles. The absence of such programmes in Russia should encourage regional and federal authorities to develop them.
Objective: to present the design of the regional suicide prevention program and to identify control points for its implementation.
Materials and Methods: data on the Suicide Prevention Strategies has been synthesized through accessible publications. Among them WHO materials, PubMed resources, information from websites of foreign and domestic governmental organizations, professional communities.
Results. The article considers the model of regional strategy for suicide prevention as a program with multi-project management, which includes five consecutive stages: preparation, planning, organization — implementation, creation of concrete results and completion of the program. The system approach of the model is to simultaneously implement its components from individual interventions to large-scale public health interventions. The strategy presented in this paper focuses on four main areas of influence: improving the health literacy of the population and the medical community on suicide, accessible and high-quality specialized care, programme research and reflection, and the establishment of a programme management system.
Conclusions: the given version of the regional suicide prevention strategy is a reinterpreted universal model, which, according to the authors, can be useful in the conditions of the national health care system.

Public organizations make a significant contribution to the development of the export of medical services: associations, partnerships, trade unions and other non-profit associations at the national and international levels, whose activities to varying degrees relate to the export of medical services. Today, many professionals participating in the medical tourism market unite in public (non—profit non-governmental) organizations for the development of the industry. Such associations help in solving a wide range of tasks (including finding partners, attracting patients, brand development, certification and accreditation, etc.). There are various levels of public organizations in the world, whose activities make a significant contribution to the development of the medical tourism market. Public organizations unite industry professionals, provide resource support for its development, form standards and quality levels of services provided and generally ensure the sustainable development of the medical tourism sector.

The article presents an analysis of mortality rate dynamics among the population of the Republic of Tatarstan from 2000 to 2022. It reflects the peculiarities of mortality rates between urban and rural populations, conducts an analysis of causes of death, and compares these rates with nationwide Russian statistics. Using statistical methods to process the data, it identifies population mortality trends and forecasts the standardized mortality coefficient for the current decade in the Republic of Tatarstan. Almost all major medical and demographic mortality indicators in the Republic of Tatarstan have lower values than in Russia as a whole. Thus, in the Republic of Tatarstan in January-October 2023, the overall mortality rate was 10.6 per 1000 people, which is lower than in the country as a whole — 11.9 per 1000 population and is the lowest in the Volga Federal District. However, the most pressing challenges of the current decade will be the general aging of the population, as a result — an increase in the prevalence of chronic non-communicable diseases, an increase in the cost of medical and preventive care for the population, an increase in the burden on the healthcare system, as well as an increase in the need for geriatric care for the population.

The article examines the judicial practice of the Russian Federation — the resolution of the Constitutional Court of the Russian Federation dated July 13, 2022 №31-P «In the case of checking the constitutionality of paragraphs 11 and 12 of Part 1 of Article 79 of the Federal Law «On the basics of protecting the health of citizens in the Russian Federation» in connection with the complaint of citizen F.», and also considers the issue of informed voluntary consent to provision of medical care without the consent of the person.
Procedures and methods. The main content of the study is a review of the decision of the Constitutional Court of the Russian Federation of July 13, 2022 №31-P, as well as 16 publications that examined clinical and legal aspects related to the maintenance of medical records. The study also used private scientific and general scientific research methods (analysis and synthesis), as well as a comparative method, which made it possible to formulate ideas about reforming the current legislation in terms of improving approaches to the legal regulation of registration and storage of medical documentation.
Theoretical and/or practical relevance. The conducted research allows us to improve the legal regulation of informed voluntary consent. The study can be used for scientific and educational purposes in studying the features of the organization of healthcare and the health of citizens in terms of organizing the maintenance and storage of medical records.

The article deals with the issues of work, staffing, principles of formation, development of the personnel potential of doctors of specialists of individual companies of medical reinforcement during the Great Patriotic War.

The article is devoted to the activities of the zemstvo medical institutions of the Voronezh province in the second half of the XIX century to combat cholera, which for seven years occupied one of the most significant places in the structure of infectious diseases in the region during this period. Based on the reports of the Voronezh Provincial Zemstvo and the Medical Department, the effectiveness of the adopted resolutions at the local level contributing to the elimination of cholera is analyzed, data on the morbidity and mortality of the population from cholera in these years are calculated. In contrast to the literature data, new indicators of morbidity and mortality from cholera in the Voronezh province have been established on the basis of archival sources. It is proved that, unlike the cholera epidemic raging in Russia, the Voronezh Province managed to localize the outbreak of infection in 1865,1870,1872,1893 with the measures carried out and prevent its large-scale spread. It is shown that the reason for the introduction of the Vibrio cholera bacterium in 1892 to the Voronezh province was the mass migration of peasants to the Caucasus to the foci of infection and back, due to famine in their homeland. The chronological framework of the study was determined by the thirty years 1865 — 1893. The beginning — 1865, the Voronezh Provincial Zemstvo Assembly was convened for the first time; the end: 1893 — the end of the epidemic.

The article is devoted to the analysis of I.P.Pavlov's contribution to the development of world science. His role in the introduction of new methodological approaches to the study of the human organism, in the development of techniques allowing to conduct long-term experiments on practically healthy animals, due to which a breakthrough in understanding the functioning of the digestive system occurred, is considered. Imperfect knowledge in the field of digestive system was corrected, supplemented and enriched by I.P.Pavlov with new important data. The world scientific community highly appreciated the Russian scientist's contribution to science, awarding him the Nobel Prize in 1904.

The article is devoted to the 175th anniversary of Alexander Alexandrovich Kadyan, Russian surgeon and public figure.