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Artigo em Russo | MEDLINE | ID: mdl-34486851


In The Russian Federation, increasing of life expectancy and decreasing of mortality related to diseases of circulatory system are the priorities of state policy. The purpose of study was to develop approaches to the classification of cardiovascular diseases by severity degree within the framework of development of general health management model based on health care activities at the regional level. The article describes methodology of calculating indices of cardiovascular diseases severity based on statistical data of appealability for out-patient, in-patient and emergency medical care. The set of balancing coefficients reflecting input of rate of accessing for various types of medical care, as well as aggravating input of concomitant pathology, based on expert evaluation of cardiologists involved is presented. On the basis of analysis of distribution of severity index in standard region of the Russian Federation, the system of criteria was developed to classify cardiovascular diseases (according to ICD-10 sub-classes) on four degrees of severity. The approbation of the proposed method demonstrated adequacy of the results obtained to judging of experts (cardiologists). So, in standard region of the Russian Federation, in the class of diseases of circulatory system (I00-I99), 79.6% of all cases are of first degree of severity, 8.6% of cases are of second degree of severity, 3.8% of cases are of third degree, and 8% of cases are of fourth degree. The methodology is unified and can be applied to classify entire spectrum of diseases by degree of severity. Besides, the proposed methodological approaches are suitable to be applied in population health management at the municipal, regional and national levels in the Russian Federation.

Doenças Cardiovasculares , Sistema Cardiovascular , Serviços Médicos de Emergência , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Humanos , Expectativa de Vida , Assistência ao Paciente
Artigo em Russo | MEDLINE | ID: mdl-32827367


The methodological approaches to total birth rate prognostication based on the study of births order-predicted patterns. The article considers issues of forecasting total birth rate as key indicator characterizing intensity of demographic processes. This problem is also relevant to the Russian Federation, since birth rates are evaluation criteria of social economic situation governing in regions. The lacking of available data in scientific methodological publications describing forecasting methods complicates understanding of demographic processes and reduces management efficiency. The methodology of predicting total birth rate states construction of causal relationships for birth rates differentiated by mother's age and birth order. The forecasting technique involves construction of multiple regression models for dependencies between the births' distributions for different birth order with the time lag parameters. To determine the delay values, iterative procedure using correlation analysis with data offset in 1-year increments was applied. To determine the time lag, offset corresponding to the maximum reliable correlations between the total birth rates depending on the children's birth of the current and subsequent order was implemented. The results obtained via correlation and regression analysis as system of equations allowed to predict total birth rate for given sequence of births from previous ones. At the same time, frequency of first births must be set following statistical series of this data. The proposed methodological approach used extrapolation of previous period trend as exponential function. Methodical approaches were tested using actual data on birth rates in a large region of the Russian Federation with a population close to 3 million people. State statistical observation form was used to perform the forecast. The results of forecasting total birth rate revealed period of temporary increase and subsequent decrease of indicator. The forecast of temporary increasing of total fertility rate is based on time lag observed between birth of the first child and subsequent children. The decreasing of studied indicator is based on negative dynamics of first births, but if the process is managed it is likely to stabilize indicator that results in its subsequent increasing.

Coeficiente de Natalidade , Criança , Previsões , Humanos , Morbidade , Dinâmica Populacional , Federação Russa