[The strategic management of laboratory diagnostic service: analysis of organization models].

The modern trends in health care (strategies of optimizing costs, value-oriented medical care) require systematic development of laboratory services for administrative territories. The study was carried out to provide support for decision-making by systematizing models of laboratory services on the basis of principles of systematic approach. Four basic models (centralization, outsourcing, horizontal integration, point-of-care) were analyzed. The study applied such research methods as analytical and strategic SWOT-analysis. The SWOT-analysis was implemented using list of standard characteristics for each model of laboratory service organization. Each model is distinguished by complex combination of strengths, weaknesses, lines of functioning and development. The availability of implementing particular model depends on delicate balance of opportunities and risks against the background of local characteristics of administrative subject. The dynamics of the social economic and infrastructural development of administrative subject can significantly affect effectiveness of model implementation. The objective set of characteristics was obtained for each model of laboratory service organization. Actually it is impossible to select particular model for specific administrative subject. Hence, scientific substantiation of "flexible" model is needed to implement.

[The diseases of digestive apparatus: the structure and dynamics at regional level].

The diseases of digestive apparatus significantly contribute into premature mortality of population. In the Republic of Buryatia, the diseases of digestive apparatus occupy third place in the structure of primary morbidity of population (6.7%) and fourth place in the structure of total mortality (6.6%). The purpose of the study is to establish characteristics of structure and dynamics of morbidity and mortality of population because of diseases of digestive apparatus in the Republic of Buryatia in 2009-2018. The analysis was based on data from state statistical reporting forms and official reports of the Territorial Authority of the Federal State Statistics Service in Republic of Buryatia for 2009-2018, reporting and accounting forms of medical organizations. The study was carried out using statistical, analytical methods, as well as elements of comparative analysis. The analysis testifies increasing of indicator of primary morbidity of diseases of digestive apparatus from 4051.0 to 4226.1 per 100 thousand of population and of mortality of diseases of digestive apparatus in the Republic of Buryatia from 60.6 to 62.5 per 100 thousand of population. The main causes of increasing of morbidity and mortality from diseases of digestive apparatus in the Republic of Buryatia are liver diseases, in particular liver fibrosis and cirrhosis because of alcoholization of population, undue diagnostics and treatment of liver pathology in the group "older than able-bodied age".

[The evaluation of compliance of medical activity to established requirements: organizational and technological support].

The ongoing process of reforming national health care system determines associated search for systems of adequate decision-making based on comprehensive and objective analysis of activities of sector objects. The results of many years research demonstrate that one of the most effective such systems is system of assessing compliance of medical activities with established requirements. It is a methodology that permits to implement systematic comprehensive analysis of health care objects and make necessary decisions on its basis. This approach is extremely important for improving control and authorization-based mechanisms, justifying necessary resource support and developing comprehensive programs of development of isolated institutions, services and industry as whole. The term "conformity assessment" was introduced for the first time in the Federal Law № 184 of 27.12.2002 "On Technical Regulation". The given law defines concept of conformity assessment as direct or indirect compliance with requirements imposed on the object. The concept presented in this law regulates industrial activity to objects and subjects of technical regulation. It is this ideology that became a basis of actual study, in which methodology and organizational technology was developed and experimentally tested to assess compliance of medical organizations and individual health services with requirements established by current legislation. Within study framework, development and experimental testing of system of assessing compliance of medical activities with requirements of regulatory documents was carried out. The object of the study was medical organizations and their structural divisions.The significant increase was established in specially developed integral compliance coefficients for studied objects for 2016-2020: from 76.5% to 82.0% for a number of medical profiles selected for the study and from 72.0% to 78.0% for medical organizations. The data obtained indicate that on the basis of a set of balanced indices, administration of monitoring objects made adequate management decisions.

[The analysis of morbidity and mortality of population because of diseases of blood circulation system].

The article presents results of comparative analysis of morbidity and mortality of diseases of circulatory system in the Republic of Buryatia in 2003-2018. The population mortality depends on identification of risk factors for cardiovascular diseases, diseases of circulatory system and subsequent coverage of population with medical care, including dispensary monitoring. The analysis was based on data from State statistical reporting forms and official data of the Territorial Board of the Federal State Statistics Service in the Republic of Buryatia, including the form № 12 "The information on number of diseases registered in patients residing in area of medical organization servicing activity"; the form № 025-12/s "The Out-Patient Registration Card"; the form № 25-2/y "The Statistical Coupon for Final (updated) Diagnosis Registration". The study was carried out using statistical, analytical and comparative analysis methods. Currently, in the Republic of Buryatia, diseases of circular system occupying second place in the structure of total morbidity (15.7%) and primary disability of adult population (28.6%) are among leading cause of total population mortality (41.6%).

[The Regional Characteristics of Preventable Mortality of Population].

The concept of preventable mortality makes it possible to assess health care reserves and to identify priorities of their improvement at the regional level. It was established that in the Republic of Buryatia during 2005-2019, the percentage of the first group by the levels of prevention of causes of death of the old list (Preventable) decreased by 6.1%, mainly due to injuries, poisoning and other consequences of external factors. The percentage of the second and third groups increased by 4.4% and 1.7%, respectively. The cause of increasing of preventable mortality are malignant neoplasms and diseases of respiratory system. The increase of mortality from malignant neoplasms made from11.4% i.e. from 166.3 (2005) up to 185.3 (2019) per 100 thousand of population caused by increasing of mortality of malignant neoplasms included in the first group (malignant neoplasms of lip, mouth, pharynx, esophagus, liver, intrahepatic bile ducts, larynx, trachea, bronchi, lungs, urinary bladder). The increasing of mortality from malignant neoplasms in the second group occurred due to malignant neoplasms of skin, including melanoma, breast, cervix, uterus. In this case, the lateness of seeking medical care, which is characteristic of a large part of population is to be considered. The dynamics of proportion of respiratory diseases in the structure of the third group was characterized by wave-like curve, with minimum in 2008 (45.3%), and maximum in 2014 (65.1%). At the same time, overall mortality of respiratory diseases decreased from 84.9 to 54.6 per 100 thousand of population. Taking into account the results of the study, it is appropriate to update existing regional preventive programs with emphasis on improving diagnostic of malignant neoplasms and appropriateness of regular preventive examinations of population of the Republic.

[Experience in working out of tools of quality management of maxillofacial prosthetics].

Expericnce of working out of tools of quality management of maxillofacial prosthetics which can be applied in clinical practice of maxillofacial orthopedy is presented. The fragment of the algorithm of maxillofacial prosthetics developed by authors is presented.

[Mediсo-organizational principles of orthopedic stomatological care rendering to patients with postoperative maxillofacial defects].

Complex research in which result key problems are revealed is done and the medico-organizational substantiation is given modern principles of rendering of the orthopedic care to the patients with maxillofacial defects.

[Optimization of hospital services extended to residents in a big industrial city]. / Optimizatsiia bol'nichnoi pomoshchi naseleniiu v usloviiakh krupnogo goroda.

Scientific approaches to optimizing the hospital medical care with respect to 3 healthcare levels (regional, municipal and departmental) are presented in the paper. An appropriate model of patient-care facilities aimed at solving the issues of intersectoral involvement of such regional, municipal and departmental institutions in implementing the Territorial Program of State Guarantees in Rendering the Free-Of-Charge Medical Care To Population is suggested.

[Study of population needs of orthodontic care]. / Izuchenie potrebnosti naseleniia v ortopedicheskoi stomatologicheskoi pomoshchi.

The prevalence of dental diseases in the population subject to orthodontic treatment is analyzed. High incidence of the main nosological entities, requiring orthodontic treatment, and the morbidity time course in different age groups are shown. Population need in orthodontic care is evaluated. Coefficients for evaluation of consumption of orthodontic care are estimated and the possibility of using these coefficients in practical public health is discussed.

[Patients' opinions of their health status and the results of medical care]. / Mnenie patsientov o sostainii svoego zdorov'ia i rezul'tatakh okazannoi meditsinskoi pomoshchi.

Anonymous questionnaires were distributed among patients of treatment and prophylaxis inpatient and outpatient institutions in the city of Irkutsk. Analysis of responses helped detect the causes responsible for the unfavorable initial health status of patients and decreasing the probability of favorable outcomes after treatment.

[Current status of health care in the USA: outlook of American scientists (review of the literature)]. / Sovremennoe sostoianie zdravookhraneniia SShA: vzgliad Amerikanskikh uchenykh (nauchnyi obzor).

The existing public health system in the USA has a plenty of problems, such as isolated infrastructure, inadequate preventive activity, complex financing, and lack of social equality as regards the availability of medical care for the population. The USA scientists consider that the up-to-date system of health protection is in need of radical reforms. Approaches to these reforms are outlined.