EVALUATION OF THE EFFECTIVENESS OF MEDICAL CARE MANAGEMENT TECHNOLOGIES WITHIN THE FRAMEWORK OF THE REGIONAL TARGET PROGRAM “COMBATING DISEASES OF THE CIRCULATORY SYSTEM”

Highlights

• The theoretical novelty of the work consists in using the regional target indicator of the mortality rate from diseases of the circulatory system as an indicator for assessing the effectiveness of management decisions at the level of municipalities in the constituent entity of the Russian Federation.
• To counteract the growing burden of cardiovascular diseases (CVD), the project solution “Long and active life” is being implemented in all constituent entities of the Russian Federation, indicating regional target indicators (RTI). A regional program is also in effect in the Kemerovo Region. In the absence of unified approaches to assessing the effectiveness of health care management technologies within the framework of the regional program, extrapolation of the RTI in municipalities seems promising for solving such a problem.

Aim. To assess the characteristics of the population’s appeal to medical organizations and the prevalence of individual risk factors for CVD in connection with the effectiveness of health care management in the municipalities of the Kemerovo Region-Kuzbass for 2019–2023.

Methods. Data from the Federal State Statistics Service for the period 2019–2023 were used. regarding mortality due to CVD, disease codes: I00–I99, and federal statistical observation forms No. 30 and No. 131/o. Statistical processing was performed using descriptive statistics methods.

Results. The average effectiveness of the regional program in the municipalities was in the range from 111.8 to 176.4%. In four municipalities, it is observed that the number of visits due to diseases exceeds the regional values. In these municipalities, the following dominate in the structure of the studied factors: poor nutrition in a share from 32 to 40.3%; hypercholesterolemia – from 3.8 to 16%; smoking – from 5.3 and 8.9%. Low physical activity and alcohol consumption do not act as a leading risk factor in the region.

Conclusion. A relationship was established between the effectiveness of health care management technologies and the number of requests for help. In particular, low efficiency is associated with a higher proportion of visits for treatment purposes compared to preventive and outpatient observation; a higher prevalence of controllable risk factors for CVD (poor nutrition, hypercholesterolemia, and tobacco smoking).

1. Russia and the countries of the world - 2022: Statistical collection / Rosstat. -M;, 2022. 400 p.

2. Address of the President of the Russian Federation to the Federal Assembly dated 21.04.2021. (Access mode: https://www.consultant.ru/document/cons_doc_LAW_382666/ date of access 15.05.2025).

3. Decree of the President of the Russian Federation of 07.05.2024 N 309 "On the national development goals of the Russian Federation for the period up to 2030 and for the future up to 2036" (access mode: https://www.consultant.ru/document/cons_doc_LAW_475991/ date of access 15.05.2025).

4. Popsujko AN, Danilchenko YV, Batsina EA, Karas DV, Kryuchkov DV, Artamonova GV. Management technologies: from theory to practical application in health care institutions. Social'nye aspekty zdorov'a naselenia / Social aspects of population health [serial online] 2020; 66(5):2. Available at: http://vestnik.mednet.ru/content/view/1195/30/lang,ru/ (accessed 15.05.2025) (In Russ.) http://doi.org/10.21045/2071-5021-2020-66-5-2.

5. "Passport of the national project "Long and active life"" (access mode: https://www.consultant.ru/document/cons_doc_LAW_504158/ date of access 15.05.2025).

6. "Passport of the national project "Healthcare"" (approved by the Presidium of the Council under the President of the Russian Federation for Strategic Development and National Projects, minutes of 24.12.2018 N 16) (access mode: https://www.consultant.ru/document/cons_doc_LAW_319209/ date of access 15.05.2025).

7. Resolution of the Government of the Kemerovo Region - Kuzbass dated June 27, 2019 N 384 "On approval of the regional program" Combating cardiovascular diseases for 2019-2026 "(with amendments and additions) (access mode: https://base.garant.ru/47042372/ date of access 15.05.2025).

8. Agienko AS, Strokolskaya IL, Tsygankova DP, Artamonova GV. Relationship between health status and lifestyle factors in patients with cardiovascular diseases. Public Health and Life Environment – PH&LE. 2024;32(1):7-14. (In Russ.) https://doi.org/10.35627/2219-5238/2024-32-1-7-14

9. Makarov SA, Popsuiko AN, Strokolskaya IL, Ageenko AS, Artamonova GV. Analysis of territorial features of mortality rates from cardiovascular diseases within the subject of the Russian Federation in 2015-2023 (using the example of the Kemerovo region-Kuzbass). Complex Issues of Cardiovascular Diseases. 2025;14(2): 99-109. (In Russ.) http://doi.org/10.17802/2306-1278-2025-14-2-99-109

10. Artamonova GV, Maksimov SA, Cherkass NV, Barbarash LS. The analysis of regional features of mortality from diseases of blood circulation system for an assessment of efficiency of health care programs. Manager of Health Care. 2013; (12): 30-38. (In Russ.)

11. Ermilova OA, Varenova LE, Pereslegina IA, Pozdnyakova MA. Methodological approach to developing an action plan to reduce mortality in municipalities // ORGZDRAV: news, opinions, training. Bulletin of the Higher School of Healthcare. 2015. No. 2. P. 131–132; Abstracts of the III International Conference "ORGZDRAV-2015. Effective Management of a Medical Organization". – Moscow, May 28–29, 2015.

12. Ermolaev DO, Ermolaeva Yu.N. Regional features of deaths from cardiovascular diseases in the context of regional program to reduce cardiovascular mortality // Medical & pharmaceutical journal "Pulse". 2021. Vol.23. №8. pp. 21-27. (In Russ.) http://doi.org/10.26787/nydha-2686-6838-2021-23-8-21-27.

13. Konovalov OE, Allenov AM, Gorenkov RV, Pak VI, Arseenkova OYu. The priority directions of forming and supporting healthy life-style in megalopolis conditions. Problemi socialnoi gigieni, zdravookhranenia i istorii meditsini. 2021;29(3):421—425 (In Russ.). http://doi.org/10.32687/0869-866X-2021-29-3-421-425

14. Lönnberg L, Ekblom-Bak E, Damberg M. Reduced 10-year risk of developing cardiovascular disease after participating in a lifestyle programme in primary care. Ups J Med Sci. 2020;125(3):250-256. http://doi.org/10.1080/03009734.2020.1726533

15. Agienko, AS. Cardioprophylaxis in your pocket / A. S. Agienko, D. P. Tsygankova // Collection of projects of the competition "All-Russian Scientific School" YOUNG MEDICINE ": V.P. Filatov International Foundation for the Development of Biomedical Technologies, Moscow, December 7, 2022. - Moscow: V.P. FILATOV INTERNATIONAL FUND FOR THE DEVELOPMENT OF BIOMEDICAL TECHNOLOGIES, 2023. - P. 876-878. - EDN TJONLQ.

16. Astrakova (Benimetskaya) K.S., Mikheenko I.L., Uranov A.E., Gartung A.A., Kovalev E.A., Spiridonov A.A., Shestova I.I., Strokolskaya I.L., Meshkova M.A., Esev L.I., Reznik А.V., Petrakovskaia V.А., Shangina A.M., Efremova Yu.E., Sergienko I.V., Ezhov M.V., Barbarash O. L., Paleev P.N. The impact of clinical decision support systems on adherence to clinical guidelines and achieving target levels of low-density lipoprotein cholesterol in patients at risk of developing cardiovascular events (SuccESS). Rational Pharmacotherapy in Cardiology. 2024;20(6):625-636. (In Russ.) http://doi.org/10.20996/1819-6446-2024-3138.

17.