[The analysis of need in medical care of elder able-bodied women with diseases of blood circulation system].

The purpose of the study is to analyze demand in medical care at diseases of circulatory system in women in age groups of 50-64 years old. The database of cases of medical care support of population age groups 50-64 years (the database of calls of Territorial Foundation of Mandatory Medical Insurance of the Moscow region) was used as primary information source. After correlation analysis of dependencies between indicators of demand in modeling, four indicators were left, three of them were volumetric and one frequency. Three blocks were used as basic causes included in Class IX "Diseases of the circulatory system" (ICD-10 version 2014-2016): 1. I10-I15 (Hypertensive diseases [Diseases characterized by high blood pressure]); 2. I20-I25 (Coronary heart disease); 3. I60-I69 (Cerebrovascular diseases). The study demonstrated that dynamics of frequency and volume indicators of medical care demand among women in age groups of 50-64 years testifies that in age range of 50-60 years there is linear or close to linear increase of demand, after which trend of increasing demand changed to downward one. The data obtained testify that age (as variable) explains considerable proportion of all fluctuations of volume of medical care in demand in women of 50-64 years. This result can be considered quite satisfactory for applying proposed model in planning volumes of medical care. It is noted that decreasing of demand increase rate is observed at age of termination of employment of majority of female population.

[The analysis of problems of supporting long-term nursing of individuals who lost their ability to self-care in Russia].

The article considers the issues of social assistance of long-term care of individuals who lost ability to self-care. The comparative analysis of established practices of social assistance of long-term care, of legal and financial support of family members implementing such a care in Russia and European countries is presented. The study was carried out using comparative jurisprudence methodology. The analysis of legislative acts of the European countries revealed possibility of including particular legal provisions concerning financing of long-term care and implementing contractual forms of regulation of employment of family members providing such care, in the Russian social welfare system. The study demonstrated inadequate efficiency of the Russian systems of legal protection and social assistance both individuals seeking long-term care and individuals implementing it, as compared with similar systems in the European countries. To improve these systems, it is necessary to recognize legislatively the care of relative who lost the ability of self-serve as labor function liable to payment based on minimum wage rate. To fix legislatively retention of workplace for caregiver for entire period of caring and/or grant him unpaid vacation for long period. It is necessary to adjust both amount of benefits for care of family member who lost ability to self-care and procedure of calculation of amount of pension benefit of caregiver. The study results can contribute to widening scientific and practical professional discussion in the field of public health, health care organization and social work concerning problems of optimization of means and modes of supporting long-term care of persons who lost ability to self-care. The study results can serve as ground for making amendments to national legislation to harmonize legal support of social welfare system and to improve protection of rights of family members caring relative who lost ability to self-care in conditions of forced loss of income.

The medical demographic characteristic of group of citizen injured in road accidents on the Federal Highway.

The role of citizen of elderly age in road accidents on the Federal Highway was principally passive since passengers of vehicles predominated (p<0,0001). The most of victims of elderly age (66,7%) suffered of combined lesions. Considering gender of victim, presence of ethanol in blood at the moment of hospitalization, the role of victim of road accident and degree of severity of lesions in citizen of elderly age was in overall higher than in citizen of able-bodied age up to 2.3-2.9 points according ISS scale. The established medical demographic characteristics of victims of elderly age condition necessity of development of differentiated approaches to their medical care support, planning of measures of population prevention of medical sanitary aftermaths of road traumatism.

[The self-evaluation of health by individuals older than able-bodied age].

Health status is one of the most valuable parameters of assessing well-being of elderly generation. It is advisable to study attitude of individuals older than able-bodied age to their own health as instrument adding to awareness of diseases or their symptoms, data concerning psychological and social well-being, degree of satisfaction with their own capabilities. Thus, in conditions of population aging, studying health self-assessment to determine prognosis of life and health of the elderly is of special actuality.

[The day hospitals as preventive hospitalization of patients of able-bodied age].

In accordance with the Russian Federal Law No. 350 of January 2019 the retirement age for Russians is increased for men from 60 up to 65 years, for women from 55 up to 60 years that requires implementation of organizational technologies of health-preserving, promotion of life and labor potential of population of late able-bodied age. In this regard, the role of day hospitals (DH) functioning directed at maximal possible prolongation of autonomous life and working capacity of elderly population increases. Besides, DH also presents additional reserve of optimization of medical care costs. The purpose of the study is to elaborate guidelines of improving activities of DH for population of late able-bodied age, for the purpose of preventive hospitalization. The study was organized on the basis of pilot medical organization of the Moscow Oblast, consisted of hospital of 600 beds and day hospital of 120 beds. The methods applied included sociological survey, expert judgment, statistical direct observation. The primary data was obtained from the forms of federal and sectorial statistical monitoring for 2014-2018. The analysis of medical documentation concerning pilot medical organization functioning during the year of the study was applied. The sociological surveys of patients of late able-bodied age (5 years before retirement according to the new legislation - men 60-65 years old, women 55-60 years old) who received treatment in day hospital. The results. The analysis of main indices of round-the-clock functioning in-patient and day hospitals in the Russian Federation in 2014-2018 established trend towards improvement of using hospital beds due to development of day hospital. However, bed capacity of hospitals is used ineffectively and experts assume that more than 1/3 of patients could receive medical care or aftercare in day hospitals. The experimental study of planning hospitalization of patients with chronic diseases at out-patient level demonstrated that 11.5% of population of able-bodied age need planned and preventive hospitalization in day hospital. The cost of treatment of patient with chronic pathology is 2-3 times lower in day hospital than in common hospital at the stage of exacerbation. It is reliable to apply at the out-patient level experience of planning hospitalization of patients with chronic pathology in day hospitals followed by performance control. The organization of functioning of day hospital and common hospital requires particular enhancement, including issues of succession, financing of the DS, the remuneration of medical personnel through effective contract determining interest of physician in early discharge of patient to aftercare in day hospital. The day hospital functioning is to be implemented in 2-3 turns. The day hospital is to be located in detached placement and the departments of base medical institution are to used in fullness. The day hospital is be used more actively for purpose of health preservation of population of late able-bodied age who. This contingent suffers of chronic pathology and is in need of preventive and health-promoting therapy in conditions of day hospital.

[The mortality of individuals older than able-bodied age because of consequences of external causes effect].

The analysis of mortality because of external causes in persons older than able-bodied age in the Russian Federation permitted to determine their high level and significant contribution into formation of age profile of mortality of persons of older age groups. The comparison of mortality rates from injuries, poisoning, and some other consequences of external causes effect in persons older than 65 years in the Russian Federation and the European countries was carried out. The high mortality due to external causes of persons older than able-bodied age in the Russian Federation emphasizes vulnerability of this age group of population and is characterized by increased victimization.

[The disorder of cerebral circulation in patients of able-bodied age].

The study was organized to evaluate influence of risk factors on hospital mortality in patients with acute stroke because incidence of stroke in patients of able-bodied age is increasing. All cases of in-patient care of patients of able-bodied age with acute stroke (n=4118) in the Tyumen Oblast clinical hospital № 2 during 2010-2018 were analyzed. The study was based on sampling data from hospital medical records. During the analyzed period, decreasing of in-patient lethality up to 34.9% in patients of able-bodied age was observed. During the period of "therapeutic window" 60% of patients of able-bodied age admitted died. The multivariate analysis was applied to assess influence of different factors on in-patient mortality. The presence of coronary heart disease increases risk of mortality up to 47.5%, Exp(Beta)=1.475, employment - up to 66.8%, Exp(Beta)=1.668 as compared to baseline risk. The presence of arterial hypertension and remoteness of symptom onset in ln (hours) (hospital admission) decreases mortality risk up to approximately 39.7%, Exp (Beta)=0.603 and up to 24.0%, Exp (Beta)=0.760, respectively (specificity - 75.86%, sensitivity - 72.18%; overall diagnostic accuracy - 75.23%). In patients of working age the presence of coronary heart disease and elder age are risk factors of stroke. The presence of coronary heart disease and employment are risk factors of in-patient mortality. Whereas presence of hypertension and employment decreases risk of lethal outcome.

[The characteristics of mortality of population older that able-bodied age in the Russian Federation in 2012-2018].

The positive trend of decreasing mortality of elderly population in all countries of the European Region in 2000-2015 was observed. In the Russian Federation the mortality of elderly population decreased up to 3,798.3 per 100 000 population in the 2018, i.e. on 14% lower as compared with 2012 (4424.6), and on 45% lower as compared with corresponding indices in 1998 (6877.0 per 100 000 population). The purpose of the study is to identify characteristics of mortality and to compare with foreign data of mortality of population older than able-bodied age in the Russian Federation. The standardized indices of mortality in 2012-2018 were analyzed. The gender characteristics of mortality levels were established. The main causes and the structure of main causes of death were presented. The comparison of mortality rates. The contribution of particular age groups into total mortality of population of the Russian Federation over the years was described.

[The characteristics of morbidity of population older than able-bodied age in the Russian Federation in 2012-2018].

The indices of population health exhibit tendency to deteriorate with age. The high level of morbidity, prevalence of chronic diseases, polymorbidity, atypical course of disease, continuous rehabilitation period, frequent complications and exacerbations are specific for individuals over able-bodied age. The purpose of study is to analyze dynamic, structure and characteristics of morbidity of population over able-bodied age in the Russian Federation. The study established specific features in dynamics and structure of morbidity of elderly population during 2012-2018. They are associated with high prevalence of cardiovascular diseases, diseases of musculoskeletal system and connective tissue. Furthermore, there is variety in morbidity rates of neoplasms, endocrine, nutritional and metabolic diseases, mental and behavioral disorders, diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism, diseases of the eye and adnexa, diseases of ear and mastoid process and also symptoms, signs and abnormal clinical and laboratory findings, not classified in other rubrics. The analysis of indices of primary and common morbidity of pneumonia in elderly population of different regions of the Russian Federation was carried out.

[The Analysis of Morbidity of Urban Population Older than Able-Bodied Age in Russia].

The aging of population ia an important social, economic and medical problem. The purpose of study is evaluating of morbidity of urban population older than able-bodied age in the Russian Federation in 2010-2014.The article presents the results of studying of primary and total morbidity of urban population older than able-bodied age according classes of diseases in the Russian Federation in 2010-2015. The analysis was applied to morbidity of narcological disorders and particular valuable diseases in population older than able-bodied age and residing in city.