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Background: In the first months after the pandemic of the COVID-19, the provision of medical care through telemedicine technologies took a leading position, in particular regarding endocrine nosologies. Meanwhile, at present, comprehensive information on telecommunications interaction between doctors of various medical organizations of the regions of the Russian Federation and employees of federal centers is insufficient, which determines the relevance of studying this topic., Aim: Analysis of the provision of medical care in remote interaction of medical workers using telemedicine technologies («doctor-doctor») between the Endocrinology Research Centre and the regions of the Russian Federation in 2019-2023., Materials and Methods: A single-center, observational, single-sample study was conducted, including completed planned and urgent telemedicine consultations in the format of «doctor-doctor « in the fields of «endocrinology» and «pedia-tric endocrinology», conducted through a telemedicine system for remote consultations at federal and regional levels between 2019 and 2023. Data on the referral rate of medical personnel from the regions of the Russian Federation to the Endocrinology Research Centre for telemedicine consultations were analyzed, including annual dynamics of treatment, frequency of referrals from each region, nosological structure of referrals, and number of patients admitted to the center based on the results of these consultations. Analysis of interdepartmental cooperation between the Endocrinology Research Centre and other federal centers was also performed., Results: In the period from 2019-2023, 14,475 telemedicine consultations «doctor-doctor» were conducted. In 2019, medical workers from 78 regions of the Russian Federation applied to the Endocrinology Research Centre. By 2023, this figure has increased to 88 (including newly annexed territories). The Yamalo-Nenets Autonomous Okrug, Tambov Region and Astrakhan Region were the leading regions in terms of the circulation of medicines at the Endocrinology Research Centre. In the nosological structure, the largest number of consultations in adult patients were conducted for acromegaly and primary hyperparathyroidism, in children for stunting and type 1 diabetes mellitus. In the period from 2019-2023, the Endocrinology Research Centre sent a total of 300 «outgoing» requests to 17 medical organizations., Conclusion: Consulting with the use of telemedicine technologies has become a convenient and multifunctional way of providing medical care. Further analysis of the place of telemedicine in practical healthcare will expand its capabilities, including considering the introduction of financing by the territorial fund of compulsory medical insurance for this area of medical activity.

In the nearest future, global health care is to be changed dramatically because of digital transformation of medicine that is supported by numerous innovative technologies. The digitization of Russian health care nowadays is priority direction of its development. It requires from medical workers to have special knowledge and readiness to apply achievements of digital medicine as effectively as possible. The purpose of the study is to analyze subjective perception of problems of digital future of national health care by students of graduation courses of regional medical university. The study was carried out using combined content analysis of 50 essays on topic of digitization of health care. The content-analysis demonstrated that despite some gaps in knowledge, young medics learned for sure that digital medicine is developing in three crucial directions: pharmaceutical industry, medical devices and pool of technologies supporting health care. The majority of respondents actively use digital devices on regular basis.The young medics are purposefully oriented on digital sphere and are ready to consume digital medical services and goods. However, they consider problem of ensuring security of personal data to be very acute. They see task of the state in resolving this issue as soon as possible.

In the context of an aging population in megacities, it is important to maintain the health and activity of older people, improving their quality of life. To do this, it is necessary to study the factors affecting longevity, including individual health characteristics and perception of the health system (accessibility, responsiveness, effectiveness, ageism)., The Purpose of the Study: to identify an assessment of the quality of life of elderly Muscovites and the influence of factors related to health and the assessment of the health care system on it., Materials and Methods: a sociological survey, descriptive statistics, correlation analysis, and a z-test were used to compare the proportions of variables., Results: an assessment of the quality of life and its components based on questionnaires showed that health is a key factor for the elderly, although its assessment was low. 47% of the elderly are committed to healthy lifestyle, of which 40% regularly exercise. 25% have bad habits, 26% are disabled, which reduces the quality of life. 18% seek medical help on a monthly basis. Those who go to doctors less often rate the quality of life higher (p m 0.001). Satisfaction with the last medical visit is higher than with the healthcare system as a whole., Conclusion: the study revealed a link between healthy lifestyle and the quality of life of the elderly. Regular physical activity improves quality of life by reducing hypochondria and potentially offloading the healthcare system. Satisfaction with the health care system also affects the quality of life and requires an increase in the availability of medical care.

Employment of applicants of pharmaceutical higher education has both positive and negative impact on the quality of educational services provided by institutions, especially in terms of knowledge and skills acquired by student. Objective is to study peculiarities of higher education employment, full-time training, and features driving them to conclude labor agreements. Materials and methods. During the study, we used juridical and comparative legal methods of analysis. Results. The study has defined the following features of the employment of applicants of higher education in the health care institutions, pharmaceutical enterprises and organizations. The current legislation provides the applicants of higher education enrolled in HEIs for full-time training with a right to make a free choice of the field of study, profession, type of occupation and work. The relationship developed between an applicant and higher education institutions are not to be regarded as an employment relationship. The working under the items of labor agreement for person who combine it with the full-time education is not a part or combination or sharing, and is considered the main place of job. Thus, it stipulates maintenance of records book of the employed worker according to the general procedure. An applicant of higher education has discretion to choose working hours (full- or part-time working day, full- or part-time working week) with taking into consideration the HEIs schedule and only in the free time. When full-time operating in frameworks of collective agreement at enterprise, institution, or organization, having accounted peculiarities of operation, non-standardized working day for some positions can be set. The current legislation stipulates possibility of employment for persons without higher pharmaceutical education to the health care institutions on the clearly defined positions. Conclusions.The country authority has created and is providing favorable conditions for the higher education applicants, practical experience obtaining by providing a possibility of free choice of field of study, profession, place of employment in accordance with the abilities and demands.

In conditions of impetuous development of national digital technologies and necessity for their legal regulation, significance and possibilities of their implementation in protecting health of rising generation during childhood decade in Russia are demonstrated. The conceptual apparatus related to discussed problem is considered. The emphasis is made on preventive aspect of intersectoral state protection of health care and rights of children and adolescents aged 0-17 years. The scale of problem is especially impressive considering number of contingent over 30 million people and interests of about 24 million of family members with children. The purpose of the study is applying analytical method, content analysis and SWOT analysis to monitor main problems of intersectoral health care and rights of rising generation in Russia in conditions of implementation of information technologies; to evaluate application of legislation in force in context of their role and effect during the Decade of Children (2018-2027); to demonstrate significance of the institution of the Commissioner for rights of child under the President of the Russian Federation.

The article considers the teaching of the discipline "Public Health and Health Care" to residents of all specialties. For analyzing attitude of residents to studying the discipline "Public Health and Health Care", as well as improvement of training physicians at the stage of residency and their full mastery of necessary competencies, survey was carried out on sampling of 424 residents of the second (graduate) year of training. The number of questions were formulated to be included into questionnaire to obtain data about respondents (age, gender, region of study, citizenship, experience of working at medical position) and to identify their attitude to the study of the discipline "Public Health and Health Care" " in residency (sections of program as practically applicable, assessment of form of teaching the discipline and use of educational technologies, including remote and digital learning, choice of universal and general professional competencies). The majority of residents (65.1%) plan to be engaged not only in direct clinical activities in the future, but also to undergo additional training in health care management and work in positions related to organizational managerial activities from position of head of department to of head of medical organizations and administration of regional health care services.

The satisfaction of patients is one of key indicators used to assess quality of medical care and its effectiveness from point of view of achieving patient-oriented results. Nowadays, the tools assessing patient satisfaction with medical care are largely applied all over the world. The world experience of monitoring satisfaction of population with medical care is necessary for better understanding of dynamics of indicator and possible forecasting of its level in Russia. The purpose of the study is to analyze existing national systems of monitoring satisfaction of patient with medical care and to identify particular established trends. The search for free access publications was implemented using such databases as PubMed, Google Scholar, ResearchGate and eLibrary. The keywords patient satisfaction, national monitoring, satisfaction trends, The sampling included 55 publications. The analysis established that in many countries measurement of degree of satisfaction of patient with medical care become routine practice and integral part of of evaluation of efficacy of both medical organizations and health care in a whole. The initial level of satisfaction with medical care depends on multitude of population variables, including predominant race, culture and nationality of population, gender and age structure, social economic conditions, level of incomes and prevalence of urban or rural population. The dynamics of satisfaction level in most countries demonstrates steady, but slow and statistically insignificant increasing of indicators, though different in various domains of satisfaction. The identified factors are to be considered both at the Federal level to formulate correct conclusions and at the regional level to develop corresponding measures.

The article presents comparative analysis of demographic, social and professional characteristics of general practitioners and district therapists in state and private medical organizations. Sociological, statistical and analytical research methods were applied. The study was carried out on the basis of polyclinics of both Moscow Health Department and Moscow private health care sector. The sampling consisted of 399 questionnaires subjected to statistical processing. It is established that in state and private medical organizations, in this group of physicians prevail women 36-55 years old, born in the Russian Federation, in Moscow, married, having children and assessing one's income level as average. Most of them received their higher education in Moscow, graduated residency in therapy and have no medical category or academic degree. The professional experience consists 10 years or more. All physicians in state polyclinics hold more than one position and in private polyclinics 8.6% of physicians are underemployment. In the state sector, paternalistic model of communication with patient is preferable, in the private sector - a collegiate one. In the state sector, the collegiate management style of CEO is convenient and in the private sector - collegiate or dynamic one. In both sectors, adhocratic organizational culture is comfortable. Against the background of readiness to proceed working in current conditions, work in another sector is not excluded. The material factor is considered as main driver of professional motivation. The social, demographic and professional characteristics of general practitioners and district physicians in both sectors of health care in the main are similar, but have their own characteristics.

The article presents comprehensive medical statistical analysis of indicators and causes of mortality of children population of the Russian Federation in 2017-2021. It is emphasized that in Russia, in conditions of extremely unfavorable demographic situation, the hyper actual task is to preserve life of every child. It is demonstrated that crucial role in mortality of children population is played by not only infant mortality and mortality of children aged 1-4 years, but also by mortality of children of older ages. The children population mortality still keeps gender and residence differences. The problem of reliable registration of infant mortality is to be revisited since part of newborns born alive are classified after birth as stillborn. Beginning from 2018, the first place was taken by the class "Injuries, poisonings and some other consequences of external causes" driving back the class "Individual conditions occurring in perinatal period". Thus, measures of preventing negative impact of social factors on children health continue to be an important component of modern system of health care of children population. The directions of measures reducing children mortality in Russia are proposed.

Objective: To perform a retrospective analysis of the commission forensic medical examinations' data of pediatric profile with identification of defects in health care delivery and establishment of their connection with unfavorable outcome., Material and Methods: The data of 3854 commission forensic medical examinations performed in the period from 2012 to 2021 regarding the evaluation of quality of health care delivery for children with the establishment of nature and type of defects in health care delivery, determination of disease (injury) outcome, identification of cause-effect relationship between the defect in health care delivery and negative disease (injury) outcome., Results and Conclusions: Defects in health care delivery were equal 9% in the studied commission forensic medical examinations. Studied data included all types of defects in health care delivery: defects of diagnosis, treatment and health care delivery. The structure of defects in various age groups differed: diagnosis defects prevailed in the age group of children aged from 29 days to 1 year; treatment defects were most frequent in children group of neonatal period and in children group aged 1-17 years. Child disability and death were negative consequences in all age groups. A direct cause-effect relationship was established between the defect in health care delivery and the negative outcome in all cases. The pathogenetically expectable correlation between the defect in health care delivery and negative outcome, represented by disability or death of a child, was considered to be the medical equivalent of this relationship.

Objective: To analyze the indicators of emergency surgical care in the Volgograd region between 2017 and 2021., Material and Methods: We summarized and analyzed primary statistical data presented in annual analytical collections of the chief surgeon of the Ministry of Healthcare of Russia «Surgical care In Russian Federation» (Revishvili A.Sh. et al.) and the Rosstat collections «Regions of Russia. Socio-economic indicators»., Results: According to analytic system outworked in the Vishnevsky National Research Medical Center of Surgery, surgical service in the Volgograd region dropped from the 64 th to the 82 nd place among other entities between 2017 and 2021. Insufficient innovative development of surgical service is evidenced by small number of surgeons, common part-time work, no dynamics in introduction of laparoscopic surgeries and high in-hospital mortality in some acute abdominal disease. Work of regional surgical service was compared with socio-economic development of region and monitoring indicators in the «Health» national project., Conclusion: Improving the efficacy of surgical service in the Volgograd region requires joint efforts of the entire regional healthcare system.

The state health care policy in Russia is directed at improving medical care quality and population satisfaction with it. The functioning of medical organizations beloning to national health care system has determinative impact on population health. The increasing of level of organization of their functioning is imposible without target manpower policy, upgrading qualification and professionalism of health care workers. The purpose of the study was to analyze personnel potential of Oblast clinical hospital, as one of leading health care institutiond of the Astrakhan Oblast. The methodologies of statistical, logical and system analysis were applied. The study used method of continuous sampling and was carried out in 2012-2021. The information sources included forms of the Federal statistical monitoring № 30 "Information on the medical organization" and № 17 "Information on medical and pharmaceutical workers". The absolute and mean values, extensive parameters modeling structure and methods of dynamic series construction were applied. The study revealed positive dynamics of increasing of number of established posts on 33.7%. The number of physical persons of hospital medical personnel (the basic increase made up to 40%) increased. It resulted in decreasing of combining jobs coefficient and in increasing of staff efficiency employment. The women consisted 65.2% of all working physicians. The mean age made 43.2 years among phycians and 41.7 years among paramedical personnel. The ratio 1.5:1 of paramedical personnel to physicians in staff list is negative factor. Alongside, ratio of physical persons of paramedical personnel and physicians decreases. It testifies necessity of increasing both established posts and involvement of more physical persons to work on paramedical personnel rates.

The development of health care system, including medical rehabilitation, in the Russian Federation is required updating nomenclature of simple and complex medical services and establishing its detailed list. The latter should integrate international experience and features of domestic health care system., Objective: To analyze the structure of International Classification of Health Interventions (ICHI) of World Health Organization (WHO) and the possibilities of its practical application in domestic medical rehabilitation system., Material and Methods: The role of ICHI and its structural logical correlations with other classifications of the WHO international classifications section has been determined. Analysis of ICHI application areas, comparison of ICHI codes and new nomenclature of medical services were performed., Results: Analysis of ICHI and new nomenclature project of medical services in the Russian Federation showed, that ICHI formed the basis for the development of a new medical services nomenclature, including a section on medical rehabilitation. The basic principles of ICHI (structure by axes: aim, action, means; codes uniqueness; hierarchical method of classification formation) and ICHI fragment associated with purposes for systems and organism functions are presented in the new nomenclature of medical services. It has been established that ICHI can be a basis for developing domestic list of rehabilitation services, the formation of which is planned in the near future., Conclusion: The development of medical services nomenclature in the Russian Federation will significantly increase the availability, funding and effectiveness of medical rehabilitation assistance.

The article considers problems of financing of palliative care and long-term care in the Russian Federation. The pattern of growth in population's need in care and provision of out-patient and medical services related with demographic changes was revealed. The main problems of accessibility of long-term care associated with reduction of the number of in-patient facilities and unresolved issue of sustainable source of financing for this type of services are demonstrated. The problem of accessibility of palliative care was elaborated. The common problem for two types of medical social services is lacking of integrated management center at the Federal level. The regulation of long-term care is assigned to the Mintrud of Russia and provision of palliative care is assigned to the Minzdrav of Russia that affects effectiveness of management and is expressed in duplication of functions, development of different approaches to determine funding channels.

The organization and implementation of quality management system in medical organization based on internal quality control and safety of medical activities, permits to implement continuous improvement of organization functioning, to eliminate errors or undesirable occurrences as well as to prevent causes of premature mortality and to contribute into increasing of indicator of life expectancy.The implementation of risk-oriented approach in management of medical organization within the framework of internal quality control and safety of medical activities is actual and necessary condition in accordance with adopted regulatory legal acts. Currently, in the healthcare system there are no developed and approved methods of developing infrastructure of risk management in medical organization. The purpose of the study: to apply the FMEA analysis and Pareto diagram technologies to quantify and rank risks of health harm in development of organizational and managerial decision-making. The sociological method was applied to identify violations in provision of medical care, including their frequency and possible risks. The FMEA analysis was implemented to each undesirable occurrence (risk), considering frequency of its occurrence. The priority number of risk (PMR) is calculated and risk register is compiled. The Pareto diagram construction technology made it possible to assess significance and to build risk matrix.

The article considers mechanisms of cooperation of medical organizations of various forms of property, intersectoral interaction with purpose to unify resources of organizations to resolve established tasks, to form large medical clusters and to organize interaction of medical organizations with recreation structures. The actuality of issue is conditioned by the fact that population health is the most important value of society. This value is ultimate condition of prosperity and well-being of any state and depends on quality of medical care and efficiency of functioning of medical care system. In many countries occurs search for new mechanisms permitting to increase quality of medical care and its accessibility. The issues of interaction private sector with state system of financing of health care and state medical organizations, including development of integration mechanisms in health care system with private medicine potentials to update health care system is agenda priority. The purpose of the study is to consider modern mechanisms of integration of organizations in health care system and practical involvement into action.

The article presents analysis of becoming of academic subject and scientific discipline "Public Health and Health Care Organization" in Russia from beginning of the 20th century to 1963. The special attention was paid to the role in their becoming and development that played the Chair of Public Health and Health Care Organization of the Pirogov Russian National Research Medical University that is celebrating its centenary in 2023-2024 academic year. The contribution into this process of its prominent scientists and heads is considered.

In connection with the growing number of people with disabilities in the Russian Federation, there is a need to improve rehabilitation care and bring it into line with international models. The article discusses possibilities of ergo-therapy in improving quality of life of people with disabilities living in nursing homes. The results of qualitative study of medical and social work in nursing homes of elderly and disabled people are presented. The purpose of the study was to identify needs in professional ergo-therapy work in stationary type institutions. The article presents the results of original study carried out in 2023 using method of interviewing medical and social workers (n = 13) in two regions (Saratov, Penza). The study permitted to identify the most acute problem areas requiring ergo-therapy to improve the quality of life of patients in nursing homes for disabled and elderly persons. The study resulted in conclusions that to improve the quality of life both of patients in residential institutions and the level of satisfaction of citizens with social policy it is necessary to organize and implement ergo-therapy service in stationary institutions. The current situation requires presence of ergo-therapists in social institutions and health care, as their role and importance in supporting patients are increasing.

The article presents brief descriptive review of manpower resources in health care of Greece, Spain and Bulgaria. It is noted that countries differ in redundancy of specialists at relative deficiency of general practitioners. The medical personnel of analyzed countries are characterized by aging, tendency to migration to other countries, deficiency of paramedical personnel and excess of required number of dentists that is especially pronounced in Bulgaria. Furthermore, accessibility of medical care is reduced by limits of number of patients per one physician established for specified time period in Greece. The salary level of physicians in these countries varies from minimal (Greece, Bulgaria) to maximal in Spain. At that, training of medical personnel is implemented according to Bologna system (bachelor course, magistracy, etc.) and is characterized by long period (4-5 years) of training physician for independent work.

On July 3, 2023, an interdisciplinary Council of Experts "The burden of COVID-19 in a heterogeneous population of immunocompromised patients - post-pandemic realities" was held in Moscow with leading experts in pulmonology, rheumatology, hematology, oncology, nephrology, allergology-immunology, transplantation, and infectious diseases. The aim of the meeting was to discuss the current clinical and epidemiologic situation related to COVID-19, the relevance of disease prevention strategies for high-risk patients. The experts addressed the following issues: 1) the disease burden of COVID-19 in 2023 for patients with immunodeficiency in different therapeutic areas; 2) the place of passive immunization with monoclonal antibodies as a method of COVID-19 prophylaxis among immunocompromised patients; 3) prerequisites for the inclusion of passive immunization of immunocompromised patients into routine clinical practice.

Currently, immunoporphylaxis reaches the population through information support, mass vaccination sites and the system of monitoring warning. The capabilities of information technologies have made it possible to monitor the patient's health at all stages of life, regardless of the place of medical care delivery (including vaccination). The use of mathematical modeling technologies coupled with the queueing theory made it possible to develop an optimum location scheme of vaccination sites. Organization of the work of vaccination centers considered the need to optimize travel arrangements of the recipients and operating costs. The integration with geographic information systems contributes to the adequate distribution of vaccination centers in densely populated areas. The availability of information support made it possible to create the following innovative vaccination solutions: "get a vaccine without ever leaving your car" (with prior registration on the website), vaccination at pharmacies (with the subsequent data transfer to the cloud storage), deployment of vaccination sites at sports and religious facilities. Compact mobile vaccination sites have proven their effectiveness in both sparsely populated areas and in places with a high throughput. Effective performance of mass vaccination centers is impossible without the use of effective information and communication technologies. The systems ensure interaction between the patient, medical professionals and software that allows you to write, read or update in real time the database located in the data storage center. The information technologies of vaccination have made it possible to create a system for continuous support of immunoprophylaxis.

Introduction: The COVID-19 pandemic has demonstrated the importance of developing a state policy to increase the attractiveness of a doctor's work and counteract professional burnout. The trust of doctors in their work determines the state of human resources in the field of healthcare. The development of an approach to the organization of monitoring the trust of doctors will allow identifying organizations at an early stage in which there is a decrease in the confidence of doctors in their activities. The purpose of the study is to develop and test a methodological approach to calculating the index of trust of doctors., Materials and Methods: To construct the index, a list of statements was developed that are applicable for a comprehensive assessment of the doctor's activities. The approbation of the developed approach was carried out as part of a pilot sociological study in which 346 doctors from different regions of Russia took part. The significance of the statements used in the assessment was confirmed by binary probit regression., Results: The analysis made it possible to calculate the index of doctors' trust for the obtained sample, equal to 62,5%. The results of the study can be used to assess the attitude of doctors to their activities both at the regional level and at the level of individual organizations. The Ministry of Health of the Russian Federation can use the results obtained to develop approaches to increasing the attractiveness of the medical profession to increase the public health of Russia.

The article examines the risks to social perception of health professions in the context of the growing popularity of generative textual and visual neural networks. The article is consistent with the growing body of research that tends to see more risks of this technology, including for healthcare. The second focus of the article - the stereotypes about health professions - is critical, as they have been associated with negative outcomes for the healthcare system. The study primarily focuses on the perception of nursing professionals as most stereotyped by the public. Using uploads from the chatGPT, Kandinsky, and Shedevrum networks, the author has investigated the neural network's embedded perceptions of the nursing profession. Reproduction of certain stereotypes has been identified in all neural networks; the appearance stereotypes (gender, age, race, uniform) are more often shared by visual neural networks, while the function stereotypes (lack of autonomy, dependence on colleagues) - by text networks. Actually, we can assume the risks of a vicious circle, when the network is trained on the largely stereotypical data, and products based on its output increase the scale of stereotypical representations during subsequent training of the neural network. Developers' efforts to avoid reproducing stereotypes are acknowledged, however, the uploads show that they are not fully successful. To prevent the spread of perceptual distortions in neural networks, it is recommended to promote their sociohumanistic evaluation. A «prompt-experiment» is proposed as a mechanism for identifying such risks.

The digital transformation of healthcare is an integral part of the priorities in modern healthcare. A striking example of the practical implementation of compliance with the basic principles of digital healthcare is the Healthy Moscow project, which has been implemented since 2021, which has become a real breakthrough in Russia in ensuring accessibility and convenience in providing medical care to the population. The aim of the project is the early prevention of chronic non-communicable diseases, the formation of a healthy lifestyle and the improvement of the well-being of Moscow residents, as well as the development of a conscious attitude to taking care of their health. Pavilions in the park areas of Moscow are an integral part of the modern medical infrastructure, providing convenient conditions for obtaining medical advice and information. The article provides information on the types of digital technologies and basic equipment that the pavilions (large and small) are equipped with as part of the Healthy Moscow project, it is shown that the introduction of digital healthcare technologies is one of the key tasks of the national strategy of Russia, which contributes significantly contribution to the successful implementation of the Healthy Moscow project.

The article deals with the issues of human resources management of a private medical organization. The author investigates the current state of the staffing of Russian healthcare: the provision of specialists in the healthcare system, professional motivation and prospects for the development of private medicine. In recent years, a system of private medical organizations has been formed in the Russian market of medical services, which provide medical care in parallel with state medical structures. Research in the field of human resource management in healthcare of a theoretical and practical nature shows that the problem of personnel shortage in the field of medicine is urgent and needs to be solved. One of the factors of insufficient staffing of medical organizations is the underinvestment of the healthcare industry over a long period and low preparedness for emergency situations and response to them, which has worsened under the influence of the rapid spread of the coronavirus pandemic. In conclusion, it is concluded that the main task of the effective functioning of a medical organization and the provision of high-quality medical services is the management of human resources. The purpose of this study is to consider the issues of human resources management of a private medical organization.

The article presents performance indicators of the capital day hospitals for the period from 2017 to 2022. The analysis has identified a high demand for this type of medical services in Moscow. A separate analysis focused on indicators of day hospitals subordinate to the Moscow Healthcare Department deployed at outpatient (polyclinic) medical facilities, as well as institutions providing inpatient care. The bed capacity structure and number of treated diseases by pediatric and adult population have been analyzed in detail. The study has identified main trends in dynamics in a number of indicators characterizing the development of hospital-replacing forms of care delivery in Moscow in recent years. The study is based on of the Federal statistical observation form # 14 - DS «Information on day hospital performance in medical organizations».

Introduction: The Russian healthcare system is in the process of transformation and changes, trying, on the one hand, to solve the accumulated problems, and on the other hand, to meet the modern agenda in the form of new challenges in the field of healthcare and rapidly developing information technologies. Meanwhile, in the course of ongoing reforms, questions of the formation and development of the intellectual potential of employees of medical organizations remain outside the brackets., Purpose: The purpose of the study is to rethink various approaches to intellectual potential, and to identify trends in this area., Material and Methods: The information base of the study was the Federal State Statistics Service data, as well as a mass questionnaire survey among doctors and nurses., Results: The study showed that the number of residents and graduate students is increasing, while the proportion of those who defended their dissertations is decreasing, so it is premature to talk about the development and growth of the base of intellectual potential in the medical field, this issue requires additional study to develop measures to reverse the situation. As a result of the study, the authors come to the conclusion that it is necessary to improve the management efficiency in medical organizations, create a favorable socio-psychological climate in the team. To solve these problems, the authors highlight the necessary areas of work of medical organizations., Conclusions: The article provides a review of theoretical approaches to the concept of «intellectual potential», identification of its role in the development and growth of organizations, methods for assessing its components. The analysis of adaptability of these approaches to the work of medical organizations has been undertaken.

Annotation. The review article is devoted to the healthcare system of Iceland, which demonstrates some of the best indicators of public health in the world at relatively low costs for a developed European country. The successful experience of Icelandic healthcare is important for Russia, on the one hand, due to the proximity of this country to many Russian regions in terms of climatic and geographical location, demography and territorial development. On the other hand, the success of Iceland's healthcare is closely linked to the development of a model, in many ways similar to the Soviet model of Nikolai Semashko, which Russia has abandoned. The authors believe that Iceland's experience can be used in the modernization of regional healthcare systems in Eastern Siberia, the Far East and the Arctic, as well as Russian healthcare in general.

The study of the level of appropriateness of the institutions for assessing qualifications of medical specialists with regard to their purpose is relevant due to a number of manifestations of the dysfunction of these institutions and the need to eliminate them. It is advisable to analyze these phenomena not only in general, but also from individual angles, including in the context of their functioning in outpatient and inpatient conditions. This perspective allows us to identify additional aspects of the dysfunction. The study was carried out on the basis of statistics of the Moscow Healthcare Department and materials of two surveys of medical specialists conducted in 2019 and 2022 by the Department. Opinions of medical personnel in polyclinics and hospitals about advantages and disadvantages of the work of institutions of accreditation and certification to get a qualification category were studied. The shortcomings were associated with the dysfunction factors. It is established that these shortcomings are ranked according to the level of significance. The most significant out of them (high workload and lessened incentives for advancement in skills) are characteristic of both types of medical institutions and their divisions, but more pronounced in outpatient settings. It is shown that a number of shortcomings were eliminated by legislation and due to the development of the infrastructure for continuing medical education. However, some shortcomings cannot be eliminated within the institutions themselves, and further reforming of the healthcare system is required.

Annotation. The review article is devoted to the healthcare system of Iceland, which demonstrates some of the best indicators of public health in the world at relatively low costs for a developed European country. The successful experience of Icelandic healthcare is important for Russia, on the one hand, due to the proximity of this country to many Russian regions in terms of climatic and geographical location, demography and territorial development. On the other hand, the success of Iceland's healthcare is closely linked to the development of a model, in many ways similar to the Soviet model of Nikolai Semashko, which Russia has abandoned. The authors believe that Iceland's experience can be used in the modernization of regional healthcare systems in Eastern Siberia, the Far East and the Arctic, as well as Russian healthcare in general.

The article examines the role of the processes of natural and migration movement of the population in changing the total population of the regions of Russia for more than two decades of the XXI century. Six possible combinations of these processes are proposed, which result in either an overall increase in the population or a reduction. During the period under review, various scenarios in a number of regions had fairly stable trends - a constant decline in the population or a stable increase in it. Moreover, such stability was determined either by a stable natural increase exceeding the migration decline, or by a stable decrease in the population as a result of a stable natural decline or migration outflow. But many regions experienced both the turbulence of reproduction and migration processes, as a result of which the overall result for population dynamics also changed. For the first time, a typology of Russian regions was carried out according to the frequency of the influence of natural and migration growth on the total population of the regions. This allowed further studies to consider the role of migration processes on the demographic aging of the population of the regions.

Introduction: For a better understanding of issues related to health-preserving activities for the benefit of city population, theoretical knowledge about the attitude and readiness of all interested parties for intersectoral cooperation is needed. The purpose of the study is to analyze readiness of the participants of health-preserving activities for intersectoral cooperation in Moscow., Material and Methods: In 2023, a one-time, one-time study of intersectoral responsibility, commitment and awareness, as well as satisfaction with individual health care (original test cards) was conducted among different participants in the health care of the population of the city of Moscow (n = 1007). From among them, participants were identified -workers of «medical» infrastructure facilities of urban space, participants-workers of other facilities (sports, culture, industry, waste disposal, transport, food, trade, education and others) and the population as a participant in intersectoral health saving., Results: The research based on the original integrated assessment methodology shows insufficient readiness for intersectoral cooperation to implement health-saving activities for the benefit of Moscow population. Immature intersectoral responsibility, literacy, motivation for teamwork noted among the participants of the unified health-preserving city space determines the lack of internal conviction that it is necessary to deal with both own health, and health of other members of the urban community., Conclusion: The data obtained can form basis for new methodological approaches to prioritize control measures to improve intersectoral cooperation between the participants of health-preserving activities in the metropolis.

The article presents analysis of reduction of bed stock, including infectious hospitals, resulted from modernization, intensification and improvement efficiency of processes in health care of Russia. The pandemic of new coronavirus infectious COVID-19 led to increase of mortality not only because of this infection and its complications, but also to large extent from a number of other non-communicable diseases because of forced changes in system of medical care. The article analyzes mortality from the coronavirus infection COVID-19 and a number of non-communicable diseases. The ways of forming reserve bed stock to reduce population mortality are proposed.

The more active implementation of innovative medical technologies, digital transformation in medical sphere, sanction restrictions resulted in complication of already existed problems in medical law and raised new questions. The necessity in improving medical legislation is obvious. The number of lawsuits concerning medical organizations and medical workers is invariably increasing. Hence request of adoption of normative legal regulations and decisions supporting effective functioning of industry and protection of rights and interests of medical organizations and medical workers. The purpose of the research is to study and to analyze current issues of ensuring rights of medical workers as one of the main aspects of modernization of modern medical law. The main normative legal acts of modern medical law were studied. The analysis, comparison, generalization and systematization of published statistical data, judicial practice, national and foreign sources of scientific publications, devoted to topical issues of modernization of legislation regulating health care and rights of health workers were implemented. The content analysis was applied to acts regulating legal responsibility and protection of rights of medical workers. The protection of rights of physicians in system of medical care of population at the present stage was investigated. A number of problems related to legal regulation of activities of health workers was established. The proposals for its improvement was summarized. The legal regulation of medical care support by multitude of normative acts makes actual issues of systematization of normative documentation. the assignment of independent sector of medical law where legal status of medical worker is to become its main institute.

The review of healthcare systems presented in the article notes the diversity of healthcare management in Greece, Spain, and Bulgaria. All these systems have more or less pronounced state subsystems with different centralization of management, the maximum level of which is represented in Bulgaria. Medical care is provided at several levels, while the provision of primary health care still requires improvement in Greece and Bulgaria. A fairly high percentage of GDP spent in these countries on healthcare does not prevent the co-financing of medical services at the expense of personal funds of citizens, including through informal payments. At the same time, in all three countries, the provision of medical care in hospitals still prevails over outpatient care.

The article presents an overview of foreign publications reflecting approaches to the definition of the essence of the concept of «professionalism» in relation to representatives of the field of health and medicine. The main personal and professional qualities of the doctor, which are associated with the concept of «professionalism» in patients, are noted. It is noted that the formation of professional behavior is influenced not only by the personal qualities of a medical worker, but also by the working environment of the medical organization in which he carries out professional activities. It is concluded that the formation of the professionalism of a medical worker should be carried out with the participation of both the employee himself and the public health system and the system of medical professional education.

The article presents a brief descriptive overview of the human resources of healthcare in Greece, Spain and Bulgaria. It is noted that they differ in the redundancy of specialist doctors with a relative shortage of general practitioners. The medical personnel of these countries are characterized by aging, a tendency to migrate to other countries, a shortage of secondary medical personnel, an excess of the required number of dentists, which is especially pronounced in Bulgaria. In addition, the availability of medical care and the limits on the number of patients for a certain time period with one doctor, established in Greece, reduce. The salary level of doctors in these countries varies from the minimum (Greece, Bulgaria) to the maximum in Spain. At the same time, the training of medical personnel is carried out according to the Bologna system (bachelor's degree, master's degree, etc.) and is characterized by a long period (4-5 years) of preparing a doctor for independent work.

The article presents review of publications and national reports concerning various aspects of functioning of health care systems of Iran and the UAE. It is noted that the state in these countries plays different role in supporting population with medical care. It is larger and more significant in Iran than in the UAE. At that, private medical organizations dominate in health care of both countries in area of out-patient care (in the UAE it expressed more intensively). The analysis of medical insurance demonstrated that in the UAE insurance systems and accessibility of medical care for citizens and expatriates differ significantly. It is emphasized that quality and accessibility of medical care in Iran was impacted by international sanctions that in the first place affected provision of patients with imported medicines. The characteristics of these health care systems include the transfer of functions of provision of medical and educational services to medical universities in Iran and implementation of mandatory private health insurance in the UAE.

Introduction: The study of the mechanisms of transmission of the SARS-CoV-2 virus is the basis for building a strategy for anti-epidemic measures in the context of the COVID-19 pandemic. Understanding in what time frame a patient can spread SARS-CoV-2 is just as important as knowing the transmission mechanisms themselves. This information is necessary to develop effective measures to prevent infection by breaking the chains of transmission of the virus. The aim of the work is to identify the infectious SARS-CoV-2 virus in patient samples in the course of the disease and to determine the duration of virus shedding in patients with varying severity of COVID-19., Materials and Methods: In patients included in the study, biomaterial (nasopharyngeal swabs) was subjected to analysis by quantitative RT-PCR and virological determination of infectivity of the virus., Results: We have determined the timeframe of maintaining the infectivity of the virus in patients hospitalized with severe and moderate COVID-19. Based on the results of the study, we made an analysis of the relationship between the amount of detected SARS-CoV-2 RNA and the infectivity of the virus in vitro in patients with COVID-19. The median time of the infectious virus shedding was 8 days. In addition, a comparative analysis of different protocols for the detection of the viral RNA in relation to the identification of the infectious virus was carried out., Conclusion: The obtained data make it possible to assess the dynamics of SARS-CoV-2 detection and viral load in patients with COVID-19 and indicate the significance of these parameters for the subsequent spread of the virus and the organization of preventive measures.

The article review the book about the Soviet health care. The analysis of its content and main conclusions is presented. The book inflicts powerful blow on myth of numerous merits, achievements, progressiveness, impeccability and humanity of the Soviet health care. The authors bring up issue of applying new theoretical and methodological basis in studying the Soviet health care. The certain directions of further study of health care in the USSR are proposed.

In 1918, the Dentistry subsection of the People's Commissariat of Health Care was organized with purpose of establishing national public free qualified state dental care. The organized institution was headed by P. G. Dauge, the dentist by education and the associate of Lenin by revolutionary activity. He developed dentistry reform plan as far back as the Revolution. The plan provided for organizing state dental clinics on the basis of requisitioned private dental offices and their former owners left without implements were to be engaged into public service. This process was regulated by the resolutions developed by the Dentistry subsection and adopted by the People's Commissariat of Health ("On the state organization of dental care in the Republic", "On labor service of medical personnel" ) as well as by numerous instructions and circulars. The main problems when organizing state dentistry became missing or inadequate financing, deficiency of equipment, required instruments, materials and medications as well as reluctance of dentists to be deprived of their offices and to change to state service. The organization of national state dental care was impeded by military mobilization of dentists and dental technicians that resulted in more than one third of specialists found themselves in the Red Army. The state outpatient clinics network, organized in conditions of war communism, decreased drastically after transition to the new economic policy in 1921.

The authors of the book under discussion on the forum speculate on subject matters and difficulties of their own and collective studies of the Soviet past. The reviews of the book prompted authors not only to reveal creative concepts, analytical approaches and methods, but also to assess state of the research field "History of the Soviet health care", its trends and deficiencies and to suggest main directions of its development.

The author, on the grounds of archival documents discovered by S. N. Zatravkin and cited in Chapter I of the new book by S. N. Zatravkin and E. A. Vishlenkova, comes to conclusion that the Soviet history of medicine as scientific discipline did not exist. The history of medicine in the USSR must be written anew, using accumulated factual base after verification with primary sources and observing the rule of source criticism and comparative method.

Two years after COVID-19 pandemic starting, the studies of patient satisfaction with medical services quality become topical again. The article presents the results of three-year project (2019-2022) of studying level of loyalty (Net Promoter Score) of legal representatives of patients of one of municipal children polyclinics. It is established that in Moscow, with implementation of first restrictive measures level of loyalty in the children polyclinic increased from 45% to 70%. In following years, level of loyalty was fixed at the level of 60%. The four groups of factors determining such changes as high level of panic moods due to pandemic, changes in organization of polyclinic functioning, energetic activity of mass media and users of social networks in glorifying image of medical workers and cultural psychological characteristics of Russians. The "optimistic", "realistic" and "pessimistic" prognoses concerning further dynamics of level of loyalty are proposed. The conclusion was made that COVID-19 pandemic served as key factor of positive changes in assessments of patients (and their legal representatives) of functioning both of particular polyclinic and the Russian health care in general. As far as each following time coronavirus infection will cause less and less concern among Russians it can be expected the requirements presented to medical services will soon increase, that means workload of medical personnel will only intensify. The following prospective directions of organizing functioning of medical institutions are proposed: monitoring of psycho-social indicators of medical personnel, implementation of telemedicine technologies, transfer of part of functionality of physicians and nurses to specialists without medical education.

The personnel plays important role in process of maintaining internal quality control and safety of medical care. The employee satisfaction with working conditions is main factor affecting professional development and competence enhancement and consequently quality of medical care. The purpose of the study is to analyze particular personnel policies of the institution and to investigate effectiveness of quality management system regarding health care services. Results. The institution implemented the model of quality management system (ISO 9001-2015) assigning significant role to proper personnel management. The sociological survey was carried out to analyze achieved results and to receive feedback from employees to improve quality management system. The results of sociological survey indicate that the most important targets of personnel policies for 65% of respondents are planning, forecasting skill, competency requirements; for 58% - organization of conditions improving effectiveness of employees; and for 51,7% - maintaining favorable team moral and psychological climate. The employees consider as preferable following ways of professional development: additional training, specialized training programs (78.5%), exchange of experience and communication between Russian and foreign colleagues (51.0%). The analysis established that 61.8% of employees of the institution assume mentoring programs would improve efficiency of new employees. Conclusions. The results of the study revealed that personnel policy of the institution can be improved through implementing particular policies regarding development of employee personal additional competency; of mentoring programs and motivation systems for employees; evaluation of employee individual contribution into achieving the goals of the institution and forming personnel reserve.

Economic and social losses due to epidemics of non-communicable diseases have put prevention and control of them on the first line in the field of sustainable development of the United Nations. The tasks of combating NCDs and risk factors within the framework of the Sustainable Development Goals require targeted actions on the part of States in the field of policy and legislation and provision of health systems with appropriate resources. In the Russian Federation, such work is being implemented within the framework of the national project "Healthcare", federal programs to combat oncological and cardiovascular diseases. Each subject takes into account the peculiarities of economic development, staffing, implementation of informatization processes, etc. The rapid pace of transformation of Moscow healthcare, its unique institutional structure allowed to form the basis for the effective development of a system of proactive dispensary monitoring of patients suffering from chronic diseases. The authors describe the process of formation of preventive work and organization of dynamic dispensary observation in Moscow. The paper presents in detail the organizational, administrative and technological resources used to create a unique system of dynamic dispensary observation. In addition, the article illustrates the personalized subsystem of dynamic dispensary observation in EMIAS and the institute of "physician assistant". The introduction of a proactive dispensary monitoring system will reduce premature mortality and disability among residents of the city. Moscow through an individual monitoring program and motivation for the responsible attitude of metropolitan patients to their health.

The Member States of the United Nations, while planning and implementing concrete measures to protect citizens health, nutrition included, experience need in sharing best practices and in coordinated recommendations, relevant to common actual challenges. The article analyzes and systematizes main official documents of the leading international organizations in the field of population nutrition from the standpoint of public health and health care in dynamics more than over 70 years. The particular emphasis is made on their implementation to adolescents and youths aged 10-24 years, who need risk approach application in resolving their urgent nutritional problems, in relationship with influencing environmental factors, lifestyle, bad habits, physical activity, etc. The policies, programs and other documents that are currently implementing in the area of numerous problems associated with malnutrition, promote adoption of their own commitments, which must be relevant, achievable, specific, time-bound, measurable. In this regard, adopted and implemented leading national documents in this area are analyzed. The practicability of implementation of the UN and WHO recommendations with their adaptation to multiple-aspect specifics of the country, as well as need in prolonging research in this area are demonstrated.

The rare diseases are characterized both by relatively small prevalence in population and complexity of medical care support of patients. In this particular case, the legal regulation of medical care takes its particular placement in health care. The uniqueness of rare diseases requires development of special normative legal acts, definitions and treating approaches. One of such approaches are orphan drugs that also are unique, complicated in development and require special legislative regulation. The article presents corresponding legislative terminology in modern Russian health care, actual listings of rare diseases and orphan drugs. The directions to improve current terminology and normative legal regulation are proposed.

The important direction of the National Project "Health Care" are improvement of primary health care system, including introduction of hospital-replacing technologies.The purpose of the study is to evaluate functioning of hospital-substituting form of home medical care (home hospitals) to population of the Russian Federation in 2006-2020.The normative legal documents regulating activities of stationary-substituting form of home medical care (home hospitals) for adults and children, reporting forms of sectoral statistical observation № 14ds for 2006-2018 were analyzed. In 2019-2020, unified data on functioning of day hospitals and home hospitals and composition of patients treated there of medical organizations providing medical care on out-patient basis was filled in form № 14ds. The in-depth analysis permitted to extract information about activities of home hospitals for adults and children and to study their functioning in dynamics for 15 years. The content analysis, statistical and analytical methods were applied.The examination of data for 2006-2020 established increasing of number of treated adult patients in home hospitals up to 27.9% and children up to 15.0%.The distribution of the number of treated adults and children in hospitals at home per 1000 of the corresponding population by subjects indicates their significant fluctuation.For 15 years, it has been established that in the structure of treated adult patients, the proportion of people with diseases of the circulatory system has decreased from 62.2 to 31.5%, the musculoskeletal system and connective tissue - from 11.7 to 7.4%; in children - with respiratory diseases from 81.9 to 63.4%, some infectious and parasitic diseases - from 7.7 to 3.0%, diseases of the digestive system - from 3.6 to 3.2%.In the country for 2019-2020 in hospitals at home, the number of treated adults significantly increased by 1.8 times, children - by 2.3 times, the composition of those treated has changed, which is associated with the treatment of patients with a new coronavirus infection COVID-19 in them under conditions re-profiling of the majority of medical organizations into infectious diseases hospitals.