Vol 63, No 1 (2019)

Introduction. Among the priorities of the strategic development of the health care system there is the telemedicine technologies implementation. Material and methods. The project was developed in the Penza State University. For the economic justification of the remote BP monitoring, the project technological scheme has been prepared, the market capacity has been assessed and competition has been analyzed, the business model and financial model of the project have been developed, and risks have been evaluated. Results. The project is deployed at the base and with the participation of the budget medical institution. The patient is provided with a tonometer with built-in GSM or blutooth module. After the patient’s BP has been measured, the data in an encrypted format is transmitted to the remote monitoring center and stored in the cloud base. For each patient, the doctor sets target and individual thresholds for blood pressure. Intermediate monitoring of BP is carried out by paramedical personnel who, in case of deviations from reference values, notify the attending physician. The patient receives feedback in the form of SMS-messages to his mobile phone: time for BP measuring, taking drugs and recommendations for the therapy correction. Payment is carried out according to the approved Mandatory Medical Insurance Fund tariff. Conclusion. The introduction of remote blood pressure monitoring will reduce the cost of providing medical care by reducing the number of hypertension complications, open up prospects for research and development of medical professionals. Fundamentally new conditions will arise for the study of chronopharmacology of antihypertensive drugs in patients with hypertension.

Introduction. Today there is no method to assess whether number of PCI-capable centers in Russia corresponds to the real needs. The aim of the study was to develop a PCI-capable hospitals necessity calculation algorithm. Material and methods. We used population densities, maximum/optimal distances (areas) to which delivery of patients with acute coronary syndrome by sanitary transport is possible and maximum/optimal areas where patients can be transported by ambulance transport. Then we calculated the density threshold values: Group 1: 53 persons/km2 or more; Group 2: 53-27 people/km2; Group 3: 27-18 people/km2; Group 4: 18-8 people/km2; Group 5: 8 persons/km2 and less. Results. Formulas were proposed for calculating the need for PCI-centers. For group 1: population/60000 people, for group 2: area/11,310 km2, group 3: area/31,416 km2, group 4 with functioning of sanitary aviation: area/70,686 km2 (additional strengthening of the prehospital medical care); in the absence of functioning sanitary aviation: area/31,416 km2 (also additional strengthening of the pre-hospital stage of medical care); for group 5: population/600,000 in large cities (in addition, the use of sanitary aviation, increased prehospital medical care, the organization of primary vascular departments). Discussion. The existing amount of percutaneous interventions in Russia is not enough to meet the real needs for this treatment. At the same time, simple multiplying of PCI-centers is not expedient. Conclusion. According to the developed algorithm, in Russia it is necessary to organize 239 PCI-centers 24/7. In regions with a high population density it is possible to combine several cathlabs in one center.

Introduction. The deepening of medical and demographic problems associated with the sharp aging of the population is an obstacle to the effective socio-economic development of countries, determining the increased interest in the problem of aging. The aim of the study is to study the features and causes of changes in age mortality in Russia of the twentieth century. Material and methods. Used a table of survival for the 1960-2000 years for Russia to calculate the components of the formula of Gompertz, the intensity of mortality and its increments, using the Excel program, and developed the computer program “Aging of populations»; the adequacy of the calculated (according to the Gompertz formula) and true mortality rate was estimated by the correlation coefficient (“r”). Results. The data obtained clearly show the presence of 4 stages of mortality change: reduction of child mortality; increased mortality of working age (20-65 years); the same mortality of retirement ages (65-85 years); increased mortality in the ages of long-livers (from 85-90 years). Discussion. It can be concluded that the improvement of medical and social care for children and pensioners reduces child mortality and produces the phenomenon of “delayed mortality” of pensioners: reducing the intensity of mortality (the rate of aging) in this age period. The latter leads to the phenomenon of inversion of total mortality for ages of long-livers (from reduced to increased). Use instead of overall intensity of mortality of its increment leads to the conclusion however, that the decrease in the rate of ageing for the ages of centenarians persists. For working person age mortality is increasing, which is obviously due to the increasing stress and environmental difficulties of modern cities. During the pension period, mortality rates are equalized for all studied historical periods. The reduction of the external component of mortality of the Gompertz formula makes the graph more linear over a longer age period (the contribution of the external component of Makeham, the constant, to the exponential component of biological aging, decreases). Conclusion. The detected trends in mortality indicate the direction of preventive and socio-medical impact on the health of the population.