Bulletin of Semashko National Research Institute of Public Health

This article examines interregional mortality inequality between Moscow City and the Republic of Tuva through a decomposition of differences in life expectancy at birth. The empirical basis of the study consists of official statistical data for 2023, which were used to construct abridged life tables for the two regions. To assess age-specific contributions to the overall gap, Arriaga’s decomposition method was applied. The calculations show that life expectancy at birth was 76.99 years in Moscow and 66.70 years in the Republic of Tuva; the total gap reached 10.29 years. The results indicate that differences are formed throughout the life course, but the largest contributions are made by the age groups 30—44, 60—74, and 75 years and older. The contribution of childhood ages remains relatively small. The findings demonstrate that mortality in Tuva has a pronounced premature character and is associated with increased risks in working and older population age groups.

This article examines the structural transformations of the academic life of Kazan State Medical Institute during the first academic year of the Great Patriotic War. The article presents new data obtained through archival research, significantly clarifying the role of the staff in preparing graduates during the first years of the War, including the so-called early graduations of doctors from Kazan State Medical Institute in 1941. The presented retrospectives of curricular changes, compared with the changing student population, reveal the pivotal roots of the 1941—1942 academic year in the development of standards and protocols for higher medical education in the Tatar ASSR throughout the War. State initiatives and the corresponding legal framework that defined the boundaries and capabilities of the administrative logic of the Directorate of Kazan State Medical Institute, which developed during the period under study, are analyzed.

The War of Resistance is an important episode in the history of healthcare in China. As the facts show, Chinese healthcare was unprepared for war. Due to the huge number of casualties at the front and the influx of refugees, the existing model of medical care for the wounded collapsed. The military medical service of the armed forces of the Republic of China also proved to be completely inadequate. In the first months of the war, Chinese Christian doctors from the China Red Cross, led by Robert Lim, took on some of the responsibility for caring for the wounded. Their work contributed to the subsequent reorganization of the medical care system for the wounded. The war was an important lesson for the Chinese authorities, showing that in order to respond to the complex challenges of wartime, the country must be provided with a significant number of medical personnel and equipment. In areas controlled by the CCP, the problem of organizing medical care was particularly acute. Without enough doctors, the CCP's medical services had to be more creative in how they helped the wounded.

Introduction. A significant proportion of patient flow in polyclinics consists of visits not related to the provision of medical care, primarily for issuing various referrals. These administrative visits create an excessive workload for primary care physicians, reducing access for patients in need. The aim of the study was to analyze the causes and structure of patient visits to a city polyclinic solely for the purpose of obtaining referrals. Materials and methods. A group interview (focus group) was conducted with 44 doctors of the City Polyclinic No. 115, Moscow, to identify and rank the reasons for such visits. Based on qualitative data, a form for quantitative registration was developed, within which doctors recorded 934 visits for issuing referrals. Sociological and analytical methods were used. Results. The ranking revealed five main reasons for visits: upcoming planned hospitalization, follow-up in specialized centers, prescriptions from private healthcare organizations, self-referral to federal/ departmental institutions, and military medical commission examinations. Quantitative data confirmed this ranking: issuing referrals prior to hospitalization accounted for 41.4% of all registered visits, while those initiated by specialized centers accounted for 32.5%. Thus, more than 73% of administrative visits are generated by these two channels. Conclusion. The study confirms the existence of a stable and significant flow of purely administrative visits, creating a non-medical workload for the polyclinic. The obtained data on the sources and structure of these visits provide a basis for specific management decisions. As priority measures, the following are recommended: regulatory optimization of «pre-hospitalization preparation,» technological integration within the Unified Medical Information and Analytical System (EMIAS) to eliminate the «courier» visit, organizational changes with delegation of some functions to nursing staff, and removal of barriers for a full transition to electronic document flow between institutions.

This article commemorates the 150th anniversary of Fyodor Nikolaevich Petrov—a Russian physician, revolutionary, historian, and Soviet state and party official. He held several leadership positions in the Far Eastern Republic, headed the Main Administration of Scientific and Educational Institutions of the People’s Commissariat for Enlightenment of the RSFSR (Glavnauka), the All-Union Society for Cultural Relations with Foreign Countries (VOKS), and the publishing house “Great Soviet Encyclopedia.” Petrov authored numerous works on the history of the Communist Party of the Soviet Union, Soviet science, and notable memoirs.

The protection of women's reproductive health, as well as assistance in the implementation of childbearing, are among the strategic objectives of Russian healthcare. The difficulties in providing them are due to both manageable factors, for example, staffing and material support for district hospitals, outpatient clinics and medical centers, as well as demographic, socio-cultural, behavioral characteristics of residents of remote settlements, climatic, weather and landscape factors, as well as the degree of infrastructure development: the development of the road network, aviation opportunities, telephone and Internet connection. The purpose of the study is to analyze the work of women's consultations in district hospitals in the Kamchatka Territory. Materials and methods. A cross-sectional study was conducted using a continuous sample of patients based on reports from district hospitals and maternity hospitals of the Medical informational analyzing centre in accordance with completed forms 32 and the insert of form 32. Results. Patients in district hospitals are usually more disciplined than in large ones. This is indicated by the fact that pregnant women get up more actively under the supervision, they undergo more mandatory routine examinations. This may be due to the specifics of small areas, greater accessibility of medical personnel, awareness of their responsibility to residents and general involvement in the life of the area. The level of seropositivity in the districts and in Kamchatka as a whole does not vary much. The lower frequency of the first screening may indicate that it is not easily accessible to residents of remote areas, often due to transport problems associated with its conduct in hospitals in Petropavlovsk-Kamchatsky agglomeration. According to the results of the first screening, the risk of chromosomal abnormalities in pregnant women from the districts was not detected, there was a lower risk of delayed fetal development, premature birth, and preeclampsia. At the same time, the second screening, which is simpler in technical terms, is performed more often than in Kamchatka as a whole. Among pregnant women the incidence of diseases, intrauterine fetal hypoxia, venous complications, diseases of the circulatory system, diseases of the endocrine system, diabetes mellitus, anemia are lower. However, the frequency of detection in regional hospitals of arterial hypertension, preeclampsia, threat of termination of pregnancy, threat of premature birth, delayed fetal development, urinary tract infection is higher in comparison with Kamchatka as a whole. Conclusions. In district hospitals, targeted work of doctors leads to higher rates of early registration of pregnant women, as well as more comprehensive coverage of the necessary examinations at an early stage. The difference between the detected diseases in district hospitals and the general figures for Kamchatka as a whole may be explained by the routing of pregnant women with risk factors and diseases to the main maternity hospitals, and the identification of a lower risk at the first screening, as well as a number of other diseases, may indicate a better state of health for women from the districts.

The article presents the experience of organizing and implementing a multidisciplinary model of personalized medical rehabilitation. It discusses the features of interaction between specialists of various profiles — a rehabilitation doctor, a physiotherapist, a physical training instructor, a psychologist, and an IT specialist — within a single digital framework. The article shows that the integration of clinical, psychological, and digital approaches enhances the effectiveness of the rehabilitation process and reduces the time required for patients to return to work and social activities.

Information technology is the basis for acquiring new knowledge, skills, and a mechanism for improving existing competencies. There are several stages of their formation: “manual”, “mechanical”, “electrical”, “electronic”, “computer era”, the present time is called the era of “network technologies”. Since the COVID -19 pandemic, information and digital technologies have increasingly been introduced into educational programs, including health-preserving ones. The goal was to study the methods of modern information technologies used in health conservation, with the subsequent creation of a chat bot aimed at some aspects of health-preserving technologies among students.

The article examines the history of the organization and activities of the scientific society of forensic physicians and criminalists at the Department of Forensic Medicine of the Sverdlovsk State Medical Institute (SSMI) as one of the regional branches of the All-Union Scientific Society of Forensic Physicians and Criminalists (VNOSMiK). In the first years after the organization of the Department of Forensic Medicine of SSMI (1936—1951), scientific conferences became the basis for the development of forensic science in the Urals, uniting forensic physicians, forensic chemists, and criminalists. A platform was created for the advancement of science and the solution of interdisciplinary problems. Under the leadership of Professor P. V. Ustinov, more than 100 meetings were held, reports were heard on various aspects of forensic medicine, including military examination, toxicology, obstetric and gynecological studies, and casuistic cases. In the second period (1951—1975), the activities of the society became official as a branch of VNOSMiK and expanded. The main areas of work were traumatology, toxicology, sudden death, deontology, and interaction with law enforcement agencies. The scientific society played a key role in improving the qualifications of forensic medical experts in the region, introducing new research methods and organizing health education work. Particular attention is paid to the contributions of Professor P. V. Ustinov, who headed the society for 24 years, as well as the participation of the forensic medicine department staff in scientific, methodological and consulting activities. The materials of the article are based on archival sources reflecting the dynamics of forensic medicine development in Sverdlovsk in the mid-20th century.

This article presents the results concerning the health status of the working-age population in Russia during the period 2017—2023. The prevalence of primary and general morbidity across disease classes was studied using modern data processing technologies applied to the Unified State Information System in Healthcare. The interpretation of the obtained results serves as a methodological justification for developing strategic and tactical scientifically-organizational and medical-preventive measures for improving medical care.

The article presents a conceptual substantiation of the inter-institutional interaction of the subjects of the formation of the population's adherence to vaccine prevention as a predictor of the socio-demographic sustainability of the region. Based on the analysis of regulatory legal documents, immunization programs and expert assessments, key actors (health management bodies, medical organizations, educational institutions, media, public organizations) are singled out and their roles in the coordination of information, educational and motivational influences are determined. The study showed that the fragmentation of interaction and the inconsistency of communication strategies reduce patients' trust in vaccination and limit the effectiveness of implemented preventive programs. An organizational mechanism for coordinating the interinstitutional interaction of entities involved in promoting public adherence to vaccination has been proposed. The study identified areas for improving the coordination of interinstitutional interaction, including the creation of unified coordination platforms, the development of integrated communication routes, and the implementation of mechanisms for medical and sociological monitoring of public adherence to vaccination. The results of the study can be used in the planning and implementation of regional and federal projects aimed at ensuring the socio-demographic sustainability of the region as a whole and at increasing the population's adherence to preventive vaccinations, in particular.

The analysis of the results of preventive medical examinations of minors revealed insufficient coverage of children with preventive examinations and negative trends in learner health. To address this issue, a specialist needs to be involved in providing medical care for minors in educational institutions.

The Krasnodar Krai health resort industry is a key sector of Russia's tourism and social and health economy, accounting for over 30% of all domestic health resort services. In the context of post-pandemic transformation, increased competition from international resorts, and rising demands for the quality of medical services, the industry faces systemic challenges: aging infrastructure, personnel shortages, fragmented government support, and a low level of digitalization. This article presents a comprehensive analysis of the health resort industry in the Krasnodar Krai. Key factors determining the region's competitiveness are identified: natural and climatic potential, accessibility of medical technologies, service level, and transportation infrastructure. A strategic development model is proposed, including the creation of a «Black Sea Coast Resort Cluster,» the implementation of digital health management platforms, the development of a «Health of Kuban» certification system, and integration with the compulsory health insurance system.

This article presents the oversight and coordinating role of governors-general, governors, and heads of regions in developing measures and activities to combat syphilis and leprosy, which have spread among the population of the Kamchatka Peninsula. It demonstrates systematic interaction with the Government of the Russian Empire on issues of recruiting medical personnel and determining socio-economic incentives for medical service in the regions. The article also explores the rationale for the construction of treatment facilities for patients with syphilis and leprosy, and discusses financial allocations.

This literature review systematizes and analyzes the key legislative acts establishing the rules and procedures for providing medical care to children with oncological and hematological diseases in the Russian Federation, with the goal of identifying both the strengths and areas of need for improvement within this system. The review covers federal laws, Russian Government decrees, orders and guidelines of the Russian Ministry of Health, and regional regulations.

Based on archival documents and memoirs, this article reconstructs the rehabilitation system for Red Army Air Force flight personnel during the Great Patriotic War in troop and army rest homes. The need to introduce this type of treatment into medical practice is explained. Facts are presented that reveal the specific work of the managers and medical personnel at these facilities. Their contributions to the medical rehabilitation of wounded aviators are noted, and information on relevant awards is provided.

The name of doctor of medical sciences, professor Margarita Abesalomovna Tumanyan rightfully belongs to the galaxy of prominent scientists who laid the foundations of radiation microbiology and immunology in the USSR. At the same time, the article is the first attempt to present her scientific biography based on the results of studying archival documents and literary materials. Previously undescribed facts of her creative activity have been established, and their chronological sequence has been compiled. The most complete assessment of her contribution to the development of science and the medical industry in our country is given.

Aim. To evaluate the economic effects of a set of organizational measures for the implementation of innovative medical technologies using the example of a regional multidisciplinary medical organization. Methods. The main (research) group (n=125) included patients who received medical care using innovative treatment methods. The introduction of these methods was preceded and accompanied by the implementation of a full range of developed organizational measures, including modules on staff retraining, optimization of clinical and diagnostic pathways, adaptation of internal regulations, and organization of post-procedural monitoring. The comparison group (n=68) included patients who received medical care using standard («routine») diagnostic and treatment methods in accordance with current clinical guidelines, but without the use of the studied BMI and associated organizational changes. The total sample size was 193 respondents. The weighted average base cost per bed-day was calculated at 453.50 rubles. This value was adopted as the base tariff for the conditional assessment of operating costs, excluding the cost of the treatment methods themselves, medications, and consumables, which made it possible to partially standardize the conditions for a comparative analysis of effectiveness. Results. In the group of patients who used innovative methods as part of the implemented set of organizational measures, the median length of hospitalization was 6.05 days (95% CI: 5.10 — 7.12 days). In the control group, who received treatment according to standard protocols, this indicator was significantly higher — 9.28 days (95% CI: 8.44 — 10.21 days). The statistical significance of the differences, confirmed using the Mann-Whitney U test, was p = 0.037. Thus, the implementation of innovative technologies in combination with systemic organizational changes made it possible to reduce the median length of hospitalization by 3.23 days. Taking into account the confidence intervals for the difference in the duration of treatment (from 2.35 to 3.48 days), the range of potential savings per case varies from 1,063.47 to 1,578.19 rubles. Taking into account confidence intervals, the total annual savings could range from RUB 35,639 million to RUB 52,888 million. Conclusion. Thus, the economic efficiency of implementing innovative medical technologies is indirect and largely determined by the quality of preceding and accompanying organizational decisions. A comprehensive approach combining technological modernization with the reengineering of clinical and management processes enables the clinical benefits of innovation to be transformed into measurable economic benefits for the compulsory health insurance system, contributing to the increased financial sustainability of healthcare organizations in resource-constrained environments.