[The Impact of Medical and Non-Medical Factors on Population Mortality: Phenotype and Behavioral Factors].

The secondary analysis of results of studies evaluating impact of genetic, phenotype and behavioral factors on indices of population mortality was implemented. The database included accessible publications in print and e-format (MEDLINE, EMBASE, ISI, Web of Science) in Russian and English from 1990 to November 2015. The heredity apparently impacts life-span of a single individual. However, there is no reliable data testifying its input into level of mortality and life-span at the population level. The human gender is the most demonstrative inherent characteristic effecting population mortality: in all countries life-span of females is higher than in males. The search of scientific proves of availability of such phenomenon as "premature aging" that, according to preliminary data, is related to conditions and style of life. The role and significance of such "traditional" risk factors as surplus body mass index, sedentary way of life is reconsidered. The dominant convictions concerning negative effect of sedentary life and surplus body weight require additional reliable argumentation. The aggressive behavior, extreme hobbies, asocial life-style increase individual risk of premature death while population mortality depends on percentage of individuals with such characteristics. The implementation of inherent characteristics of human organism in many respects depends on conditions and style of life of a particular individual. The prevalence of risk factors in population has no linear relationship with level of mortality.

[The Evaluation of the System of Mandatory Medical Insurance by Medical Workers of the Moscow Oblast].

The article considers the results of sociological survey of medical personnel of the Moscow oblast. The purpose of study is to analyze attitude of medical personnel to the system of mandatory medical insurance in modern conditions. The sociological survey carried out according standard methodology using originally developed questionnaire. The public opinion of medical personnel of medical municipal organizations of the Moscow oblast was investigated in 2013 (n = 632) and 2017 (n = 798). It was established that, 25 years later from the moment of organization of the system of mandatory medical insurance, not all medical personnel is oriented in it. The percentage of those who consider it as a false and over bureaucratized one increased. The number of respondents considering that medical insurance organizations protect interests of patients decreased and those who feel no impact of mandatory medical insurance foundations on activities of medical organizations increased up to 35%. The most of respondents consider functions of medical insurance organizations and mandatory medical insurance foundations exclusively as controlling ones. In both surveys less than 30% of respondents supported actual system of mandatory medical insurance. The general results of the sociological survey testify the necessity of changing policy of relationship between the system of mandatory medical insurance and medical personnel, including activization of activities concerning explanation of tasks, functions and authorities of mandatory medical insurance foundations and medical insurance organizations and also consensual consideration of opinions of all participants of the mandatory medical insurance system.

[The evaluation of costs: standards of medical care and clinical statistic groups].

The article presents the comparative analysis of techniques of evaluation of costs of hospital treatment using medical economic standards of medical care and clinical statistical groups. The technique of evaluation of costs on the basis of clinical statistical groups was developed almost fifty years ago and is largely applied in a number of countries. Nowadays, in Russia the payment for completed case of treatment on the basis of medical economic standards is the main mode of payment for medical care in hospital. It is very conditionally a Russian analogue of world-wide prevalent system of diagnostic related groups. The tariffs for these cases of treatment as opposed to clinical statistical groups are counted on basis of standards of provision of medical care approved by Minzdrav of Russia. The information derived from generalization of cases of treatment of real patients is not applied.

[Organizational and methodological approaches to using digital X-ray fluorography in the diagnosis of lung diseases in practical public health care of the Russian Federation]. / Organizatsionno-metodicheskie podkhody k primeneniiu tsifrovoi rentgenofliuorografii v diagnostike legochnoi patologii v prakticheskom zdravookhranenii Rossiiskoi Federatsii.

On the basis of a great body of information, the authors propose the most reasonable and effective organizational and methodological approaches to further actively introducing digital lung fluography into Russia's practical public health care. The paper discusses a diversity of topical problems associated with the practical use of digital X-ray fluorography (DXF), such as the assessment of its use depending on the level (municipal or regional) of public health care, methodological issues of its performance, current relationships of DXF and film fluorography; a place of DXF in the screening and routine clinical diagnosis of lung diseases. Great emphasis is laid on the role of DXF in the diagnosis of tuberculosis and cancer of the lung. The place and role of Russian manufacturers of digital lung fluorographs in the further development of SXF in practical public health care of Russia are also touched upon. The authors emphasize that replacement of film fluorography by digital one will present difficulties if regional and municipal health administrators do not take an active part in this matter.

[Interaction of cationic surface-active antiseptics and serum albumin by the bacterial bioluminescence method]. / Otsenka vzaimodeistviia kationnykh poverkhnostno-aktivnykh antiseptikov s syvorotochnym al'buminom metodom bakterial'noi liuminestsentsii.

Human serum albumin binding of cationic surface-active antiseptics was studied using a Photobacterium phosphoreum K3 strain isolated by the authors in the Black sea. Binding of cationic surface-active proteins to serum albumin led to disappearance of toxic and antibacterial characteristics of miramistine, ethonium, and decametoxin, but not chlorohexidine. The activity of chlorohexidine was reduced by 45-48% in the presence of albumin. Albumin binding capacity towards miramistine was 7.0-8.7%, towards ethonium 8.2-10%, and towards decametoxin 2.4-3%.

[Health insurance in the Russian Federation]. / Meditsinskoe strakhovanie v Rossiiskoi Federatsii.

The need to reform health care in Russia became evident in the late 1980s when due to socioeconomic crisis, the government could not cover the expenses connected with this field and put the up-to-date expensive technologies into life. The introduction of the compulsory health insurance system (CHIS) is aimed at: 1) obtaining an additional financial source for health care by making the goal-oriented stable rates of deductions from the wage fund; 2) protecting the Russian Federation citizens' rights to have free medical aid of the guaranteed scope; 3) enhancing the quality of medial care delivered to the population by introducing a mechanism of movement of funds paid for a patient; 4) paying for medical care in relation to the volume and quality of the work done by simultaneously controlling the stipulated use of funds. Three-year experience of CHIS in Russia has indicated that there is a real mechanism of reformation and government regulation of health care under the conditions of transition to the market, with the interests of the general population and medical personnel in mind. Obvious legal, organizational, technological, and psychological problems and disadvantages have been found at all management levels, which are an obstacle in the way of the reforms and which whip up social tension and call for prompt decisions.

[The results of a comprehensive evaluation of the health status of the population, of public health resources and of the socioeconomic status of the territories of the Russian Federation]. / Nekotorye rezul'taty kompleksnoi otsenki sostoianiia zdorov'ia naseleniia, resursov zdravookhraneniia i sotsial'no-ékonomicheskogo sostoianiia territorii RF.

Population health in the Russian Federation was assessed over the course of 5 years using a universal method with ranking of territories according to Euclidian distance, which is a variant of cluster analysis. The same method was used in study of the ratio of territories as to their provision with public health resources and some resultant socioeconomic parameters. Under condition of the socioeconomic crisis involving the whole country, the population health rapidly reacted to changes by developing new and progress of the existing negative tendencies, which led to shift of some territories, particularly of the Northern ones, in the ranked series. As a rule, there are more problems with population health at territories with more strained socioeconomic situation.

[Several results of the experiment on improving public health management in a city]. / Nekotorye rezul'taty éksperimenta po sovershenstvaniiu upravleniia zdravookhraneniem goroda.

The experimental approbation of new conditions of economic activities revealed a discrepancy between the development of health service network and manpower potential and needs of population in medical care, the possibility of priority development of primary health care, promotion in the development of "semi-hospital" forms of medical care organization, the excessive level of hospital care, the interest among workers in increasing the volume of work and increase of effectiveness in the utilization of resources under normalization of economic relations in public health.

[Public health reforms in Hungary]. / Reforma zdravookhraneniia v Vengrii.

Hungarian public health services are experiencing changes the purpose of which is to establish fixed and guaranteed receipt of financial resources for public health and social welfare, to entrust health insurance bodies with power to command credits, to change the mechanism of financing public health institutions. It is expected that hospitals would be financed on the basis of national system of DRGs being developed since 1986 or according to the principle of "fee-for-service". The Hungarian experience indicates that the changeover from the state system of public health to the insurance medicine requires some time.

[Evaluation of medical services in public health institutions in experimental setting]. / Otsenka meditsinskoi pomoshchi v usloviiakh éksperimenta v uchrezhdeniiakh zdravookhraneniia.

The paper provides an analysis of the results of a socio-hygienic survey of 2099 residents of Leningrad and Novokuznetsk of Kemerovo Region on the state of public health in the course of a comprehensive economic experiment on the introduction of new economic methods of management. Only 5.6 percent of respondents defined the state of public health as good, 54.1 percent as satisfactory and 40.3 percent as poor. Negative attitude to public health is explained by low level of medical care and poor organization of health care delivery and not by introduction of a new economic mechanism. The majority of respondents (33.4%) believe that their health status to a large degree depends on the system of public health rather than on their efforts to keep healthy lifestyle.

[Prospects of using diagnostic related clinico-statistical groups in Soviet public health]. / Perspektivy ispol'zovaniia metoda diagnosticheski-sviazannykh-- kliniko-statisticheskikh grupp v sovetskom zdravookhranenii.

The evolution of Medicare prospective payment for medical services is described. A comparison is provided of the peculiarities in the standards of health technologies developed in our country and abroad. An evaluation of possible ways for the development of the current trend under planned system of health care is provided.

[Hospital activity related to a stage II experiment regarding intensification of the use of hospital beds]. / Deiatel'nost' statsionarov bol'nits v usloviiakh II étapa eksperimenta po intensifikatsii ispol'zovaniia koechnogo fonda.

It is pointed out that there are some reserves for significant intensification of the use of the existing resources in inpatient establishments. Organizational measures, material stimulation of the hospital staff and financing of hospitals per patient enable one to increase the amount of medical care provided by each hospital. The experimental results indicate the potentiality of satisfying the population's claims for inpatient care without increase of bed fund capacity.

[Determination of conventional economics of financial resources in experimental intensification of hospital bed fund utilization]. / Opredelenie uslovnoi ékonomii finansovykh resursov v éksperimente po intensifikatsii ispol'zovaniia koechnogo fonda bol'nits.

The intensification of bed fund utilization calls for the extra spending which are needed, at least, for the material stimulation of personnel and purchase of medicaments. The expenditures involved in the conducting of the experiment are substantially lower than those generally required for the treatment of additional number of hospitalized patients. On the average, in the course of 2 years, 1 rouble of extra expenditures results in 2 roubles of conventional economy. The intensification of bed fund utilization allows to meet the needs of the population in hospital care without expanding the existing network of hospitals.