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This paper aims to investigate the essence and method of building a financial model of healthcare in Russia. The author applies methods such as analysis and synthesis, statistical data processing, systemic and structural approaches. This article is an analysis of the basics of building a budgetary and insurance model: cost allocation (various types of medical care, individual costs) by funding sources; system of inter-budgetary relations; the structure of expenditures of the budgetary system of the Russian Federation on healthcare in 2019. The study presents the financial model of the compulsory medical insurance (СMI) system and defines the role of insurance and private medical organizations in the CMI system. The mechanism of financing state (public) healthcare institutions is shown. The procedure for financing medical organizations according to the territorial program is considered (as illustrated by the example of the Irkutsk region). The article analyzes the methodology for calculating the cost of the territorial program and identifies the problems associated with it. The author pays special attention to organizations that do not carry out activities in the field of compulsory medical insurance, outlining the specifics of financing and legal regulation, and arguing the reasons for excluding a number of diseases from the compulsory medical insurance program. The paper examines the content of the new law on the CHI reform, which provides for direct financing from the budget of the Federal CHI Fund of federal institutions providing specialized medical care. The author highlights the main problems of the building of the budgetary and insurance healthcare funding model such as congestion, inconsistency, cost intensity. The author concluded that it is necessary to revise the organization of the healthcare system and mechanisms for its financial support. The outstripping growth in healthcare costs, on the one hand, and inadequate funding of medical institutions, on the other, lead to a constant search for a compromise between equity and cost-effectiveness. Based on this, the author substantiated the goals and determined the directions for further research, such as reducing transaction costs, changing the motivation of participants, identifying cost growth factors and the possibility of eliminating them.

The paper considers principal features and specific character of architectural design for health care institutions. Main designing stages, missions and complexities for every successive designing step have been revealed in the paper. The paper presents specific features, main stages and design approaches to designing of modern health care facilities, comfortable architectural environment of health institutions, which have been formed on the basis of the analysis of advanced international experience in the field of designing healthcare facilities. The proposed approaches are based on modern experience in designing medical buildings over the past decade in the developed countries. A special attention has been paid to obsolete methods for architecture-planning organization of healthcare facilities and modern approaches to arrangement of engineering and other systems which significantly influence on economical efficiency, quality, comfort and effectiveness of architectural environment in healthcare institutions. Every healthcare facility, every separate department are considered as unique in their essence, for this reason it is not so easy to reflect modern technological solutions and architectural tendencies. The paper contains an attempt to attract attention of architects to the complexity in designing of a building to be constructed, to find ways which will help to reach its step-by-step solution. It has been noted as well that there is a necessity to arrange interaction between an architect and a medical technologist. Modern medical departments and hospitals have been recently designed and built in the Ukraine, but they are in increasingly short number. These facilities have been constructed due to decision makers who, in spite of diverse difficulties, lack of information and specialists, lack of proper funding, etc., are trying to do their best in order to reach the modern level of desingning and construction of hospitals. So-called “typical” medical projects of 70-ies and 80-ies continue to be implemented up to now. This is certainly due to inadequate funding, but such economy has at the end rather high cost.

The subject of the research is healthcare financing systems in European countries and Russia. The relevance of the problem stems from the possibility of using successful foreign experience for the organization of healthcare financing in Russia. The purpose of the research was to examine the specific features of the establishing and funding healthcare models in countries of Europe and the possibilities of their experience in organizing healthcare financing in the Russian Federation. The paper examines the current state of the two models of health financing in the EU — budget funding and insurance. By the example of individual European countries, the operation specifics of each model are analyzed, their advantages and disadvantages are assessed. Particular attention is paid to the specifics of the healthcare financing system in Russia and its difference from foreign systems. Taking into account the foreign experience and the need to improve the Russian compulsory healthcare insurance (CHI) system, the paper proposes ways to improve the Russian model of healthcare financing: establishment of a unified organizational and financial CHI model; introduction of a system of equal participation of the employer and employee in the financing of compulsory healthcare insurance; introduction of a family insurance system; promotion of voluntary healthcare insurance programs. It is concluded that the keypoint in the CHI system restructuring should be the search for socially acceptable and economically justified forms of attracting public funds. At the same time, it is extremely important that the funds received by medical institutions do not increase the shadow incomes in the economy but are spent on the development of the healthcare system.

Целью настоящего исследования была оценка положения России на глобальном ландшафте, созданном публикациями, посвященными вопросам использовании технологии блокчейна в здравоохранении. Определено место Российской Федерации по удельному весу в общем числе статей, индексируемых в международной базе данных Web of Science. Обнаружено 957 релевантных публикаций, проиндексированных в международной базе данных Web of Science Сore Сollection (WOS СС) за период с 2014 г. (год появления первой статьи) до конца 2020 г Анализ распределения этих публикаций по странам аффилиации показал, что 23% портфеля публикаций подготовлено исследователями из США, 20% опубликовали ученые и разработчик Китая, 10% — Индии. Россия с показателем 11 публикаций занимает скромное 27-е место, уступая Саудовской Аравии (10-е место), Пакистану (11-е место), Бразилии (12-е место), Румынии (23-е место), Вьетнаму (26-е место). Выполнен анализ сегмента высокоцитируемых публикаций (Highly Cited Papers), посвященных преимуществам и рискам применения блокчейна в здравоохранении, сформировавших фронты исследования за последние пять лет., The aim of the study was to assess the position of Russia on the global landscape, created by publications devoted to blockchain technology applied in healthcare. The authors determined the place of the Russian Federation by its share in the total number of articles indexed in the international database «Web of Science». The international database «Web of Science Collection» (WOS CC) includes 957 relevant publications in the period from 2014 (the year of the first article) to the end of 2020. The analysis of the distribution of these publications by affiliated country showed that researchers from the United States contributed 23% of the publication portfolio, scientists and developers from China published 20%, with India providing 10%. Russia is ranked 27th with 11 publications, behind Saudi Arabia (10th), Pakistan (11th), Brazil (12th), Romania (23rd), and Vietnam (26th). Authors analysed the sorted list of highly-cited publications (Highly Cited Papers) on the advantages and risks of blockchain application in healthcare which formed the research basis during the past five years., Врач и информационные технологии, Выпуск 1 2021, Pages 25-39

В работе показано, что характерной особенностью развития высшего образования в современных экономических условиях является расширение спектра исследований, появления направлений, связанных с здоровьесберегающей деятельностью. Университет сегодня - современный вертикально интегрированный образовательный комплекс, единство стандартов, методик и программ которого гарантирует неизменно высокое качество подготовки молодых специалистов. The paper shows that a characteristic feature of the development of higher education in modern economic conditions is the expansion of the spectrum of research, the emergence of areas related to health-saving activities. The University today is a modern vertically integrated educational complex, the unity of standards, methods and programs of which guarantees a consistently high quality of training of young specialists.

The article is focused on attitudes of healthcare workers towards their health. The outbreak of the COVID-19 pandemic, followed by a substantial increase in media coverage of public health-related issues, has dramatically altered many people’s normal routines and caused a shift in our collective perception of normal. In this context, examining the attitudes of health care workers toward their health becomes particularly topical as this group possesses first-hand knowledge about the pandemic and various medical subjects. We consider medical professionals as specially-trained people who possess evidence-based knowledge about our body, mental, and physical health. Since it is a challenging job that involves being in close contact with people who are sick or recovering from illness, the risks of which have been exacerbated by the pandemic, this group has privileged access to professional medical services. We conducted a quantitative sociological survey among medical professionals who work for the Moscow Health Care System. This research allows us to analyze patterns of health care utilization and health behavior among health care workers and the correlation between their attitudes and perceptions of the problem and the actual patterns of their behavior. This paper aims to answer the following question: how do the level of medical knowledge and privileged access to a wide range of health care services and resources affect the attitudes toward one’s own health that are common among the so-called expert groups?

Health status of the younger generation in Russia is of particular relevance, since it is this period that forms the development potential of future generations.Objective. To study and analyze regional features of the incidence rates of the adolescent population in Russia.Material and methods. The authors have used various literature sources, statistical reports; the method of studying and generalizing experience. For the statistical analysis of the morbidity dynamics they used the indicators of absolute and relative growth, they assessed the chain and basic growth rates. Also the authors generalized the characteristic of the incidence dynamics by means of regression analysis.Results. The paper provides a detailed analysis of the incidence of the adolescent population in the Russian Federation in 2012–2018. It describes the dynamics and structure of both primary and general morbidity, identifies classes of diseases with a stable trend of growth, and compares with similar indicators in other countries; the authors analyze the regional characteristics of the incidence of adolescents; compare the level of morbidity in the Russian Federation for all classes of diseases.Conclusion. The authors revealed classes of diseases, characterized by a stable increase in indicators of both primary and general morbidity: neoplasms, endocrine diseases (obesity), eye diseases, injuries. Thus, the article identifies the directions for the health care system that require special attention and development of specific measures to reduce the level of these diseases. The results of the study demonstrate a low medical activity of adolescents, which should be taken into account when developing a set of measures aimed at increasing the coverage of adolescents with medical examinations.

The concept of a 'health care realm' is introduced. The healthcare realms considered were those patients who have only Physical Health Problems (PH), patients with neither physical nor mental health issues and who are seeking advice to remain healthy (HP), patients only with Mental Health Problems (MH), patients with both Physical Health and Mental Health Problems (PH&MH) and patients with Psychosomatic Health conditions (PS). Described is how patients' minds and bodies interact and its relevance to rheumatology practice. Presented is the culmination of 34 years of the author's experience of rheumatological disorders based in Family Medicine in a United Kingdom General Practice. Also presented are 2 small studies supplementing the main conclusions. The first small study counted the main consultation content of 246 patients, as considered by the principals in the practice. Of these 73.5% were for physical health conditions, 13.3% for health promotion, 11.5% for mental health conditions and 1.8% for psychosomatic conditions. The second small study was a survey of experienced GPs, Physicians and Psychiatrists, asking about their opinions on how well the patients in different health care realms were being managed across the healthcare system. Of the 5 realms, the collective view was that it was the patients in the PH realm who was clearly received the best care. The least good care was being given to patients in the PS realm and only marginally better were patients in the MH Realm. This paper argues that clinicians need a different thinking approach when meeting patients from different healthcare realms. It is known that when doctors treat PH patients, they consider the patient's symptoms against templates of knowledge for the conditions in the differential diagnosis. Furthermore, HP patients are assessed by comparing the patient's bio-measurements against known markers of good health When being consulted by patients in the MH or PS realms, it is advocated, not to follow the approach of PH patients. For patients in the MH realm it is best to address the patient's life as a whole and to consider, how did the person arrive to the situation he is in and what needs to be done to restore the patient's life back on track. For patients in the PS realm, ideally the aim is to help the patient make the link between the physical symptom and its psychological aetiology. A step towards this is to describe how the body physically mediates the symptom.

The aim of this paper was to investigate the influence of an increase in government healthcare expenditures on regional economic growth in Russia. Studies have shown that an increase in healthcare expenditures stimulate an increase in GDP through several channels. Firstly, it improves the quality of labor force, which can lead to an increase in labor productivity. Secondly, an increase in productivity and size of labor force lead to consumption expansion and then to firms’ income growth, so there is a multiplication effect. Including the assumption that the relationship between healthcare expenditure and economic growth may be non-linear we formed the hypothesis of the existence of the average optimal share of healthcare expenditure in GRP that maximizes average regional economic growth rate. In this research it was suggested that an increase in healthcare expenditures besides the direct effect on economic growth of a particular region also affects economic growth of neighboring regions. The possible explanation of this is the positive impact of healthcare services received in the neighboring regions on nearby territories, joint national healthcare projects, and distribution of scientific knowledge. Using the spatial Durbin model focusing on regional data of 2005–2017, it was shown that the average optimal share of healthcare expenditures equals to 5,9% of GRP with an inclusion of spatial effects and 7,6% without them, outlining the importance of including interconnection variables between Russian regions into the model. The regional statistics analysis showed the failure to reach the recommended share by most Russian regions, which can be viewed as a possibility for economic growth stimulation in case of the increase in governmental spending on healthcare in the future

The paper presents an analysis of the state of the sphere of social work with migrants and problems in this sphere in Russia through the prism of expert assessments obtained during interviews with employees of government bodies, non-profit organizations, volunteer movements, and scientists. The main difficulties that migrants face during the adaptation are paperwork, access to information, legal and financial difficulties, employment issues.Analysis of the opinions of experts made it possible to identify measures of social work with migrants aimed at raising awareness, legal literacy of foreign citizens, increasing their legal protection, improving access to health care and education, housing, and the labor market, improving the professional skills of migrants and their knowledge of the Russian language, the history and socio-cultural foundations of the life of Russian society.Based on the results of the interview, the recommendations of experts in the field of social work with migrants and the possibility of applying unified social work practices that can improve the effectiveness of the system of social work with migrants and their families in Russia were highlighted. According to experts, integration with the host community allows migrants to adapt faster and more efficiently. In this regard, the role of non-profit organizations (national cultural organizations for the preservation and development of cultures, the House of Friendship of Peoples) that preserve the cultures of peoples and develop a dialogue between them is growing.Experts emphasize that in the sphere of social work, both at the state level and in the work of non-profit organizations, more attention should be paid to the possibility of applying unified practices that can improve the effectiveness of the system of social work with migrants and their families in Russia.

В глобальной перспективе мало исследователей рассматривают лабораторную диагностику как интегральную часть всей системы здравоохранения. Актуальна систематизация данных о развитии лабораторной диагностики в России с целью анализа совершенствования организации и управления, внедрения принципов ценностно-ориентированного здравоохранения. Проведен селективный обзор литературы. Велся поиск глубиной 20 лет научных публикаций на русском языке. Включались оригинальные и дискуссионные статьи, обзоры, опубликованные в рецензируемых научных журналах. Многочисленные исследования посвящены улучшению организации службы лабораторной диагностики на основе международных и оригинальных подходов. На фоне возрастающих запросов на объемы, доступность и качество лабораторных исследований, многие вопросы эффективной организации службы остаются не решенными. В субъектах России реализуются различные организационные подходы, обычно их выбор не имеет научно-методологического обоснования. Наиболее изучена модель централизации, но ее применение часто ограничено. Требуется разработка практико-ориентированных способов выбора модели развития лабораторной службы субъекта России, включая систему критериев для объективной оценки применимости модели в конкретных условиях., Laboratory medicine is a leading topic of healthcare research. However, even in a global perspective, only a few researchers consider laboratory diagnostics as an integral part of the entire health care system. It is relevant to systematize data on the development of laboratory diagnostics in the Russian Federation in order to analyze the improvement of organization and management, and introduce the principles of value-oriented healthcare. There is a selective review. The search for scientific publications made in the Russian-language bibliographic database of the Russian Science Citation Index (Russia). The search depth was 20 years, and included original and discussion papers, as well as reviews published in peer-reviewed scientific journals. The laboratory service is an important component of the healthcare system in the Russian Federation. Numerous studies are devoted to improving its organization. For this purpose, both international approaches and original decisions are used. Nevertheless, many issues of effective organization of the service remain unresolved. While their relevance is constantly increasing at the background of increasing demands for the volume, availability and quality of laboratory tests. In administrative divisions of the Russian Federation, various organizational approaches and models implemented, but their choice often does not have a scientific and methodological justification. The model of centralization has the largest evidence base, but it is not the only one, and often it is fundamentally not realizable. Practice-oriented methods for choosing a best model of laboratory services in a specific administrative division (also as a system of criteria for an objective assessment of the model’s applicability in specific conditions) should be create in further research., Бюллетень Национального научно-исследовательского института общественного здоровья имени Н.А.Семашко, Выпуск 1-2 2022, Pages 26-35

В данной работе изложен Ð¼ÐµÑ Ð°Ð½Ð¸Ð·Ð¼ государственно-правового регулирования медицинской помощи населению в ÑƒÑÐ»Ð¾Ð²Ð¸ÑÑ Ð¿Ð°Ð½Ð´ÐµÐ¼Ð¸Ð¸. Рассмотрена система органов государственной власти, Ð¾ÑÑƒÑ‰ÐµÑÑ‚Ð²Ð»ÑÑŽÑ‰Ð¸Ñ Ñ€ÐµÐ³ÑƒÐ»Ð¸Ñ€Ð¾Ð²Ð°Ð½Ð¸Ðµ в сфере Ð·Ð´Ñ€Ð°Ð²Ð¾Ð¾Ñ Ñ€Ð°Ð½ÐµÐ½Ð¸Ñ. Изучены правовые средства, принимаемые государственными органами в ÑƒÑÐ»Ð¾Ð²Ð¸ÑÑ Ð¿Ð°Ð½Ð´ÐµÐ¼Ð¸Ð¸ для предотвращения распространения коронавирусной инфекции. Проанализирован организационно-правовой Ð¼ÐµÑ Ð°Ð½Ð¸Ð·Ð¼ деятельности Ð³Ð¾ÑÑƒÐ´Ð°Ñ€ÑÑ‚Ð²ÐµÐ½Ð½Ñ‹Ñ Ð¾Ñ€Ð³Ð°Ð½Ð¾Ð² Санкт-Петербурга в период пандемии. Выявлены практические проблемы в организации Ð¼ÐµÑ Ð°Ð½Ð¸Ð·Ð¼Ð° государственно-правового регулирования в сфере Ð·Ð´Ñ€Ð°Ð²Ð¾Ð¾Ñ Ñ€Ð°Ð½ÐµÐ½Ð¸Ñ и предложены возможные пути и способы Ð¸Ñ Ñ€Ð°Ð·Ñ€ÐµÑˆÐµÐ½Ð¸Ñ., This paper outlines the mechanism of state-legal regulation of medical care to the population in a pandemic. The system of state authorities that regulate in the field of health care is considered. The legal means and instruments adopted by government agencies in a pandemic to prevent the spread of coronavirus infection have been studied. The organizational and legal mechanism of the activities of state bodies of St. Petersburg during the pandemic is analyzed. The main theoretical and practical problems in the organization of the mechanism of state-legal regulation in the field of health care are identified and possible ways and means of their resolution are proposed.Â

Mental health services are perceived differently in different socio-cultural settings. The connotations accorded to mental health, especially in terms of need awareness and evaluation of alternatives, vary from culture to culture. Understanding these differences is critical to attract and retain patients suffering from mental conditions. Generic literature on consumer behavior does not provide direct answers to many of the problems in this regard, primarily because such literature does not take into account the deviant mental states of these patients. In this paper, we review findings from mental health specific studies conducted in both Western and Asian countries, evaluate the importance of decision-making factors for both public and private service providers, and offer directions for future research. Interdisciplinary literature on customer relationship management, consumer behavior, mental health, and healthcare marketing, guided by the principles of systematic literature review constituted the methodology of this study. The research methods are analysis, synthesis, classification and grouping. The empirical base included about 250 peer-reviewed articles on the topic under consideration. We find that doctor-led service provision is still the most prevalent form of relationship building in the Eastern societies, especially in the less developed countries of South East Asia. Consumer-initiated mental health treatment schemes are more common in more developed Western economies. We also observe that, among the innovative set of providers, there is a trend of increased use of telehealth. Among other things, this includes more proactive and digitally-savvy identification, acquisition, and retention of patients. The results of the study can be used as the basis for marketing strategies of drug manufacturers and mobile application designers in the field of online medical services.

This paper reviews concept issues of vaccination in Russian Federation. There are three periods of vaccination history. The provisions of the concept were formulated on the basis of the results of multi-year researches and analysis of data from domestic and foreign studies. Main provisions aim at: reconstruction of domestic vaccine production; improvement of the national immunization schedule and public policy for country biosafety; promotion of the WHO strategy for full immunization throughout life in Russia; development of the national immunization schedule for adults and monitoring system for adverse events following immunization; implementation of vaccination risk management and epidemiological surveillance for disease prevention, improvement of vaccination compliance among people, health care workers, mass media, legislative and executive authorities. Implementation of the provisions of the modern vaccination concept in Russia would contribute to solving demographic problems, to reduce morbidity and mortality, to promote active aging, and would have a significant economic effect.

Osteoarthritis (OA) is currently considered as a heterogeneous disease that can be represented by different subtypes. It is the study of OA phenotypes that is one of the strategic areas for the development of researches on this nosological entity, which will further allow a personified approach to patient therapy and ensure the rational use of financial resources of health care.The paper describes in detail the current researches on this issue. It discusses attempts to identify different OA types according to demographic data (age, race, gender, etc.), comorbidity (including depression), nature of pain (intensity, pathophysiological mechanisms of its development), biochemical markers, genetic and biomechanical predictors, hormonal status in patients, and structural changes detected by ultrasound, magnetic resonance imaging, and computed tomography, etc.

The article pertains the main problems faced by manufacturers and consumers of paid medical services. The increase in the volume of paid medical care prevails in the fields of dentistry, diagnostics and cosmetology. Of course, the expansion of voluntary medical insurance in almost all areas of medicine, further digitalization and gradual development of commercial outpatient care will be promising areas in the domestic health care. After all, currently every fourth outpatient medical organization is private owned. In this regard, taking into account the foreign and domestic experience of modernization of the medical services market, the paper comprehensively analyzes the trends in the development of commercial medicine within the legal, organizational and socio-economic regulation of the health care industry. Marketing tools to optimize the system of paid services are presented. The key role of mechanisms of public-private interaction in health care management is proved. Integrative approaches to the problems of introduction and development of paid medical services, considered in this study, will allow to systematize and to adjust the extra-budgetary activities of medical organizations while simultaneously increasing the availability and quality of medical care in Russia.

The paper considers the criteria and indicators by which it is possible to evaluate the effectiveness of budget spending during the audit, as well as problems that exist in the Russian legislation during the implementation of this project type of audit. в работе рассмотрены критерии и показатели, по которым можно оценивать эффективность расходования бюджетных средств при аудите, а также проблемы, которые есть в Российском законодательстве при проведении данного вида аудита

Состоянию современного аграрного сектора экономики уделяется недостаточное внимание в обществе, имеющиеся трудности замалчиваются властями. Между тем бытовая неустроенность и скудность культурной жизни наблюдаются в большинстве сел и деревень. Данные проблемы имеют глубокие исторические корни. Целью исследования является анализ перемен, произошедших в повседневной жизни крестьян под влиянием политико-просветительской деятельности советского правительства в первое послереволюционное десятилетие. Предметом исследования являются законодательные материалы правительства и директивы партии, задающие общий тон просветительской работе в деревне; материалы делопроизводства органов власти Нижегородской губернии, освещающие особенности реализации указаний центра на местном уровне; статистические материалы, позволяющие сравнить динамику изменений. Особое место занимают материалы местных периодических изданий, углубляющих представление о проблемах в сельскохозяйственном секторе в рассматриваемый период времени. Малограмотность, широкое распространение инфекционных болезней, недостаточное количество медицинских пунктов, отсутствие культурно-досуговых учреждений и др. являлись распространенным явлением в крестьянской среде. Автор приходит к выводу, что именно с утверждением советского строя данные вопросы стали активно обсуждаться во всех эшелонах власти, а также были выработаны конкретные пути их решения. В исследовании раскрываются изменения, произошедшие в образовании, здравоохранении, внутрисемейном укладе, в работе культурно-досуговых учреждений на селе. Большое прогрессивное значение имели такие меры, как обучение грамоте широких слоев населения, развитие интереса к чтению, распространение сельскохозяйственных знаний. Эффективной мерой для борьбы с инфекционными заболеваниями стала вакцинация населения. Продолжением идеи социального равенства являлось повышение правового статуса женщины. В 1920-е гг. жители сел и деревень впервые познакомились с радио и кино, появились специализированные крестьянские периодические издания. Негативным явлением данного периода следует считать широкое распространение антирелигиозной пропаганды. Материалы данного исследования могут быть использованы на учебных занятиях по отечественной истории, а также при написании научных работ, посвященных рассматриваемому историческому периоду., Insufficient attention is paid to the state of the modern agricultural sector of the economy in society, the existing difficulties are hushed up by the authorities. Meanwhile, domestic disorder and scarcity of cultural life are observed in most villages and villages. These problems have deep historical roots. The purpose of the study is to analyze the changes that occurred in the daily life of peasants under the influence of the political and educational activities of the Soviet government in the first post-revolutionary decade. The subject of the research is the legislative materials of the government and the party directives that set the general tone for educational work in the village; the materials of the office work of the authorities of the Nizhny Novgorod province, highlighting the peculiarities of the implementation of the center's instructions at the local level; statistical materials that allow comparing the dynamics of changes. A special place is occupied by the materials of local periodicals that deepen the understanding of the problems in the agricultural sector in the period under review. Low literacy, widespread spread of infectious diseases, insufficient number of medical centers, lack of cultural and leisure facilities, etc. they were a widespread phenomenon in the peasant environment. The author comes to the conclusion that it was with the approval of the Soviet system that these issues began to be actively discussed in all echelons of power, and specific ways of solving them were also developed. The study reveals the changes that have occurred in education, health care, the intra-family way of life, in the work of cultural and leisure institutions in rural areas. Such measures as teaching literacy to the general population, developing interest in reading, and spreading agricultural knowledge were of great progressive importance. Vaccination of the population has become an effective measure to combat infectious diseases. The continuation of the idea of social equality was to increase the legal status of women. In the 1920s, residents of villages and villages first got acquainted with radio and cinema, specialized peasant periodicals appeared. The widespread spread of antireligious propaganda should be considered a negative phenomenon of this period. The materials of this study can be used in educational classes on national history, as well as when writing scientific papers on the historical period under consideration., Вестник гуманитарного образования, Выпуск 2 (22) 2021, Pages 37-44

Приказом Департамента здравоохранения Москвы с 27 марта 2020 года Городская клиническая больница № 15 имени О.М. Филатова Департамента здравоохранения Москвы перепрофилирована для приема пациентов с вирусными пневмониями, в том числе с COVID-19 подтвержденной инфекцией. Возникшие в связи с перепрофилированием сложности по обеспечению лечебно-диагностического процесса, соблюдению санитарно-эпидемиологических правил в отношении больных/контактных новой коронавирусной инфекцией и сотрудников больницы, потребовали мобилизации всех сил и ресурсов больницы, дополнительного оснащения, закупки непрофильных лекарственных средств. В статье описываются организационные решения, принятые руководством ГКБ № 15 имени О.М. Филатова для работы в измененных условиях. Представлена информация, касающаяся оказания медицинской помощи, прежде всего стационарной, пациентам с новой коронавирусной инфекцией. Описана модель оказания медицинской помощи и результаты клинико-аналитической работы различных подразделений ГКБ № 15 имени О.М. Филатова. Опыт диагностики и лечения инфекции, ее осложнений и серьезных конкурирующих заболеваний основан на тысячах пролеченных в клинике пациентов, наблюдений за течением заболевания каждого из них, серьезном аутопсийном материале, результатах десятков тысяч инструментальных и сотен тысяч лабораторных исследований., According to the order of the Moscow City Health Department of March 27, 2020, the Filatov State Clinical Hospital no. 15, was reprofiled to treat patients with viral pneumonia, including COVID confirmed infection. Difficulties in providing treatment and diagnostic process, observance of sanitary-epidemiological rules in respect of patients/recent contacts with new coronavirus infection and employees, which arose due to reprofiling, required mobilization of all forces and resources of the hospital, additional equipment, purchase of non-core medications. This paper describes organizational decisions made by the management of Filatov State Clinical Hospital №15, to work in the changed conditions. Article provides information about the provision of medical care, primarily inpatient care, to patients with a new coronavirus infection. The experience of diagnosing and treating infection, its complications and serious concurrent illness is based on thousands of patients treated in the hospital, surveillance of the disease each of them, on the results of tens of thousands instrumental and hundreds of thousands laboratory tests., Бюллетень Национального научно-исследовательского института общественного здоровья имени Н.А.Семашко, Выпуск 4 2020

Results of sociological research of problem questions of regulation of personnel processes in the medical organizations are presented in this article. The problem of reforming medical organizations is characterized. Proposals on the solution of currently important problems of personnel regulation in medical organizations are formulated.The purpose of the research is to substantiate the directions of improving the management of personnel processes in modern medical organizations based on the sociological analysis of personnel processes and relations in medical organizations.Materials and methods. The paper presents the results of a sociological study of the condition and problems of regulation of personnel processes in medical organizations. The survey involved 240 respondents from among the employees of medical organizations and 97 qualified medical experts.Results. It is proved that the successful functioning of medical organizations is possible with a scientific approach to the management of personnel processes and relations, including analysis of personnel policy issues, sociological support of personnel processes regulation, development of human resources technologies in modern medical organizations.Conclusions. Successful functioning of medical organizations is possible with a scientific approach to the management of personnel processes and relations, including analysis of personnel policy issues, sociological support of personnel processes regulation, development of modern personnel technologies in medical organizations. Achievement of effective management of personnel processes in medical organizations requires the development and implementation of scientifically sound human resources policy in the health care system, improving the regulatory and organizational support for the regulation of personnel processes, enhancing the role of self-regulatory organizationsin the management of personnel processes in medical organizations.

The paper presents the analysis of the work and resources of dermatovenereologic healthcare organizations in Russian Federation, the results of hospital and day hospital beds restructurisation, medical service density, hospital bed usage, incidence of sexually transmitted infections and skin disorders in Russian Federation in 2013-2015.

Obesity prevention is a priority in health care. The paper gives the results ofstudies of the prevention of overweight and obesity in childhood. It discusses specific practical recommendations concerning antenatal prophylaxis, a balanced diet, complementary food, and infant feeding tactics. Inclusion of functional foods as an important component of dietary measures to prevent obesity is warranted.

Статья посвящена важному аспекту материальных условий жизни семей работников сферы здравоохранения Свердловской области. Для этого автор исследовал такой значимый показатель качества жизни указанных граждан, как денежные расходы на приобретение непродовольственных товаров и осуществление нетоварных расходов и платежей. При написании статьи были использованы в первую очередь материалы ежегодных посемейных бюджетных обследований, хранящихся в фондах Государственного архива Свердловской области (ГАСО) и текущего архива Территориального органа Федеральной службы государственной статистики по Свердловской области (ТОФСГССО). Представлен подробный анализ уровня денежных расходов семей наиболее типичных медицинских работников – врача, медицинских сестер и лаборанта. The article analyses the material conditions of health care workers’ families in Sverdlovsk region. The author has examined such an important indicator of the mentioned citizens’ quality of life as expenses on manufactured goods and non-market expenses and payments. The researcher has used the materials of annual fiscal surveys of the State Archives of Sverdlovsk region, the current archives of the Territorial Office of the Federal State Statistics Service of Sverdlovsk region. The paper analyses in detail the level of monetary expenses of the families of most typical medical workers – a physician, a nurse and a lab assistant.

The state pays special attention to the issues of observance of the constitutional right of convicts deprived of liberty for health protection. Along with international acts, the laws and by-laws of the Russian Federation are aimed at ensuring the rule of law in the system of implementation of the constitutional rights of convicts serving a sentence of imprisonment. The paper deals with some problems of realization of the constitutional right of convicts deprived of liberty to health protection, and some issues of legal of public relations in the field of monitoring the legality of the execution of punishment in the penitentiary system and ways to protect the right to health protection. The statistical data show that the level of violations in the sphere of material and household, medical and social security of persons serving sentences in places of deprivation of liberty is reduced in the Altai territory. In addition to the existing methods of protection of the right to health protection, there is a need to legally expand the scope of powers of public monitoring commissions, specify the duties of the penitentiary system in cooperation with the monitoring commissions, determine the timing and forms of information, as well as a clear legal regulation of access to documents of the penal system and personal data of prisoners deprived of liberty., Вопросам соблюдения конституционного права на охрану здоровья осужденных к лишению свободы уделяется особое внимание со стороны государства. Наравне с международными нормами законы и подзаконные акты Российской Федерации направлены на обеспечение законности в системе реализации конституционных прав осужденных, отбывающих наказание в виде лишения свободы. В работе рассмотрены отдельные проблемы реализации конституционного права осужденных к лишению свободы на охрану здоровья, а также некоторые вопросы нормативно-правовой регламентации общественных отношений в сфере осуществления контроля за законностью исполнения наказания в учреждениях пенитенциарной системы и способах защиты права на охрану здоровья. Статистические данные свидетельствуют о том, что на территории Алтайского края сокращается уровень правонарушений в сфере материально-бытового и медико-социального обеспечения лиц, отбывающих наказание в местах лишения свободы. Помимо действующих способов защиты права на охрану здоровья существует необходимость в легальном расширении объема полномочий общественных наблюдательных комиссий, конкретизации обязанностей органов пенитенциарной системы при взаимодействии с наблюдательными комиссиями, определении сроков и форм предоставления информации, а также четкой правовой регламентации доступа к документам уголовно-исполнительной системы и персональным данным осужденных к лишению свободы.

The rapid growth the number of joint replacements in the second half of the XX century required the creation of a system for monitoring the results of these operations. The most promising organizational structure that takes into account the number of performed surgeries and evaluates its results, is a national arthroplasty register. Followed by Sweden, where the first time the National Register of knee arthroplasty was created in 1975, many countries in Europe and North America began to develop own registers in the field of traumatology and orthopedics. By publishing annual reports and scientific papers, as well as through participation in national and international conferences, register distributes information to doctors, health care administrators, manufacturers and other interested bodies, allowing to track the results of arthroplasty at all levels, from the certain hospital to the international level. The authors of this review provide the analysis of the structure of existing registers of knee replacement and compare it with randomized clinical trials.

The article is devoted to the problem of development of professional-subjective position of managerial staff of health care in the system of continuous professional education in the conditions of optimization of activities of the health system. Professional and subject position reflects the position of individual managers in a professional environment, its relationship to the quality of professional activity, to himself, to patients and colleagues to level their skills. Purpose/objectives: analysis of core competencies, forming the professional and subject position of heads of medical organizations; identify possible ways of development of professional-subjective position of managerial staff of the public health based on the use of modern technologies and active methods of training in system of continuous professional education. Methodology. In conducting the present study used data from official sources, literature review, scientific methods of analysis and synthesis, comparative analysis and modeling. The results of the study indicate the necessity of actualization of the subject position of heads of medical organizations. Conclusions /Significance. The necessity of formation and development of professional subjective position of the heads due to the needs of society and the health care system with modern requirements for quality management training of health. Professional and subject position is a characteristic feature of a highly qualified specialist in the area of governance, reflecting its active attitude toward self and professional activity, factor of efficiency of activity of medical organizations. The real practice of activity of medical organizations requires improved approaches in the preparation of healthcare managers. Most of the leaders are having difficulties, associated not only with necessity of development of universal and professional competences, but also the necessity of development of professional-subjective position, professionally important personal qualities, personal interest in self-development and improvement. Despite the large number of scientific papers in the fi eld of managerial activities, a broad educational possibilities of managerial staff of health care in the system of continuous professional education, the problem of formation and development of professional and subject position of health care managers remains relevant and requires further development. The development of the leader as a personality, a subject of professional activity, formation of an active professional position is the most important task of the system of continuous professional education of managerial staff of health requires improved organizational, technological and methodological support of the educational process, adequate methods and training technologies, assessment of level of readiness of the expert to implement a professional-subjective position in terms of professional practice.

Epilepsy is a chronic brain disease that requires a long-term or lifelong follow-up of patients. The factors that influence the outcome of therapy are various; moreover, the key factors of them are the organization of care and the mode of patient follow-up. The necessity of optimizing the specialized health care to this category of patients stems from the poorer quality of life in the patients and their families and from the more frequent development of mental disorders and drug-resistant forms of the disease during ineffective therapy. These and other issues are considered in this paper with emphasis on the specific area – the south of the Tyumen Region. This underlines the importance of setting up not only highlevel epileptologic centers, but also a whole network that provides access to specialized epileptologic care. It seems today that it is more appropriate to solve problems in the organization of management for epileptic patients at the level of an administrative region, for this state structure has all necessary conditions for rapidly and rationally implementing the most successful developments of specialized care to the population.

The criteria allowing to assess health of the urban population within functional approach is considered in the paper. The analysis was carried out with use of sociological methods. The factors influencing social action are established. Solutions of the problems connected with violation of balance of social interests in the sphere of health protection between urban population and owners of means of production are offered / В статье рассмотрены критерии, позволяющие в рамках функционального подхода оценить здоровье городского населения. Анализ проводился с использованием социологических методов. Установлены факторы, влияющие на социальное действие. Предложены пути решения проблем, связанных с нарушением баланса социальных интересов в сфере охраны здоровья городского населения и собственников средств производства

Статья посвящена материальным условиям жизни одиноко проживавших (в силу разных причин) работников сферы здравоохранения Свердловской области. Для этого автор исследовал важнейший показатель качества жизни указанных граждан - уровень их денежных расходов. При написании работы были использованы материалы бюджетных обследований Государственного архива Свердловской области (ГАСО), текущего архива Территориального органа Федеральной службы государственной статистики по Свердловской области (ТОФСГССО) и Центра документации общественных организаций Свердловской области (ЦДООСО). Представлен подробный анализ уровня денежных расходов двух наиболее типичных медицинских работников - врача-терапевта и медицинской сестры. The article examines living conditions of health care workers, who lived by themselves in Sverdlovsk region. The author analyzes the key indicator of the mentioned citizens’ living standards – the level of their monetary expenses. The researcher used the materials of fiscal surveys of the State Archives of Sverdlovsk Region, the current archives of the Territorial Office of the Federal State Statistics Service of Sverdlovsk region and the Center of Documentation of Public Organizations of Sverdlovsk region. The paper analyzes in detail the level of monetary expenses of the two most typical medical workers – a physician and a nurse.

The paper deals with one of the priority tasks of Russian educational system – developing the health responsibility. The recent health deterioration trend among children and adolescents calls for the complex health care measures, equally affecting the learning outcomes. The authors argue that there is a need for proper definition and specification of the key term of health care quality. However, the analysis of the available scientific and documentary recourses demonstrates the absence of such unified definition. The authors describe the existing approaches to defining the health care quality, and examine structural components of the health care activity, their interrelations and interdependence. In authors’ opinion, the synthesis of the available research materials provides the basis for further studies in the theory and practice of quality management activities regarding the health protection of children, adolescents and young adults in educational institutions.

The paper is devoted to the correlation between the employees’ significant professional characteristics and the effectiveness of their performance in social spheres implying interpersonal relations. The representatives of different social sectors were surveyed including the managers of different levels in education, health care and social services. The research methods combine the test-questionnaires by V. V. Stolin, S. R. Panteleyev, R. Shvartser, M. Yerusalem, B. Romek V. M. Morosanova, R. R. Sagiev, as well as the author’s questionnaire for evaluating the professional effectiveness level. The research findings reveal the statistically significant correlation between professional effectiveness in the given spheres and stress resistance, social courage, tolerance to uncertainty, social-communication skills, positive self-attitude, absence of self-condemnation and failures avoidance. However, in other aspects the correlation between the professional levels and competences differ depending on the professional spheres. In author’s opinion, the research outcomes need some additional consideration and investigation.

В работе анализируется отток населения из Сибирского федерального округа. Для объяснения сложившейся ситуации предлагается сравнение условий жизни между регионами России. В качестве критериев сравнения выбраны обеспеченность жильем, услугами здравоохранения и образования. Использованы данные государственной статистики РФ. There is the analysis outflow of population from Siberian Federal District in the paper. Author comparing life conditions in different region of Russia for explanation this process. As comparison criteria selected housing security, medical care and education service according to state statistics.

Anastasiya Karavay - Research Fellow, Center for Economics of Lifelong Learning, Institute of Applied Economic Research, Russian Presidential Academy of National Economy and Public Administration. Address: 82 Vernadskogo Ave., 117606 Moscow, Russian Federation. E-mail: karavayav@yandex.ruIn this paper, we analyze the rates of participation of Russian workers in continuing professional education (CPE) using Rosstat data and sociological surveys, including the 2014 and 2015 Eurobarometer in Russia. We reveal considerable differences in the percentages of workers covered by CPE across age cohorts, personnel categories, and especially industries. Our analysis shows that formalized CPE norms and standards in such industries as education and healthcare have a largely positive effect on the incidence of employee participation in advanced trainings. Next, we demonstrate that the data collection methods used by Rosstat do not allow for a comprehensive analysis of CPE participation rates in all industries, as only large and medium-sized companies are covered by the official statistics, while small businesses, which form the best part of the retail sector, are left out. Besides, the rigid regulatory framework of the official statistics makes it impossible to embrace the diversity of existing types and forms of CPE. There is no single method to measure the rate of participation in continuing education (not only professional), which we demonstrate in our review of methodologies used by Russian and foreign researchers. As a result, comparing the rates of participation in lifelong learning (including CPE) in different countries becomes a challenging task.

В статье раскрываются основные противоречия между нормами гуманистической морали и требованиями российского законодательства, возникающие при реализации прав людей, не имеющих постоянного места жительства, на получение квалифицированной медицинской помощи. Выделяется проблема готовности медицинских работников к оказанию помощи людям, создающим в ряде ситуаций своим поведением опасности для их здоровья и жизни. Приводится опыт ряда стран Европы в создании особых форм оказания медицинской помощи самым бедным слоям населения. The article considers the discrepancies between the norms of humanist morality and the health legislation in the Russian Federation. This discrepancy affects the way some groups of Russian population, the homeless in particular, can exercise the right to qualified medical aid. The paper also outlines the relevant European experience in providing special forms of medical assistance to marginalized population groups.

В статье представлена проблема социальной эксклюзии иностранной рабочей силы в российской системе медицинского обслуживания. Противоречия медицинской помощи трудовым мигрантам показаны на основе анализа нормативно-правовой базы, а также результатов эмпирико-социологического исследования, проведенного социологами Приволжского федерального университета. В работе указываются проблемные зоны при реализации механизмов добровольного медицинского страхования. The article is presented the problem of social exclusion of migrant workers in Russian system of medical service. On the basis of analysis of legal acts and the results of sociological research conducted by sociologists of Volga Federal University are shown the contradictions of health care of migrant workers. The paper emphasizes the trouble spots in the realization of mechanisms of voluntary health insurance.

В работе рассмотрены особенности взаимодействия врачей и пациентов в системе сельского здравоохранения. Опираясь на результаты опроса пациентов и медицинского персонала в статье указывается, что взаимодействие строится на идеологических основах патернализма, который воспроизводится медицинским персоналом, а пациенты стремятся к коллегиальной модели взаимодействия. The paper discusses the features of the interaction of a physician and patient in the system of the rural public health. Based on the results of the research of patients and the medical staff in the article indicates that the interaction is founded on the paternalistic ideology that is reproduced by the medical personnel but patients tend to the Collegial model of the interaction.