REMEDIUM

The problem of low patient referral rates for drug-related diseases to healthcare facilities, leading to high latency of drug-related pathology among the population, requires the development of new organizational solutions that help reduce stigmatization and discrimination against patients. The objective of the study was to develop a patient-oriented model for organizing the provision of medical care by psychiatrists-narcologists to individuals with previously unreported drug-related diseases. Materials and methods. The model was studied based on the drug treatment service of one of the largest constituent entities of the Russian Federation — the Samara Region. Organizational and methodological management of the drug treatment service is provided by the Samara Regional Clinical Narcological Dispensary (SRCD). Specialized medical care in the profile of “psychiatry-narcology” is provided in five drug treatment units of the SRCD located in the cities of the region: Samara, Tolyatti, Syzran, Novokuibyshevsk and Chapayevsk, and in 30 drug treatment offices in other cities and municipal rural districts of the region. The staffing level of psychiatrists-narcologists as of the end of 2023 exceeded 90%, with the number of individual psychiatrists-narcologists being 107 people. Based on the analysis of the activities of the narcological service of the Samara region, the literature and the regulatory framework for the provision of medical care to patients suffering from drug-related diseases were studied to develop a model for organizing the provision of medical care. The following research methods were used: content analysis, analytical, organizational modeling. Results. A low-threshold patient-oriented model for organizing the provision of medical care for individuals with an unreported drug-related disease, in the absence of signs of substance abuse syndrome, has been developed. The model is based on the reorganization of the routing of drug-related patients; organization of outpatient appointments in the offices for the prevention of drug-related disorders of the drug-related dispensary using special speech modules, involving psychologists and psychotherapists for diagnostic and psychocorrectional work to identify and eliminate the causes of drug use; use of the “Doctor—Patient” software product for better communication during dispensary observation. Conclusion. Since 2023, a patient-oriented model for organizing the provision of medical care by psychiatrists-narcologists to people with previously unregistered drug addiction has been developed and implemented in the Samara Region, demonstrating its effectiveness and not requiring significant financial costs. Currently, the results of the medical, social and economic efficiency of the implementation of this model are being assessed.

The current global trend of national health systems is determined by the fact that investments in citizens' own health are considered as an effective mechanism for reducing economic costs and for increasing the level of economic well-being of the country. Considering that health is a fundamental condition for the effective functioning of human potential and plays a key role in socio-economic development, especially in the context of accelerating modernization and digitalization of society, its development is becoming an important factor contributing to an increase in the economic potential of the state. The relevance of this study is due to the importance of the problem of rational use of investments in the development of public health. The article describes investments in physical activity of the population as an important factor in ensuring a healthy lifestyle of the population. It also shows the specifics of the implementation of the state voucher program aimed at reducing the cost of participating in structured physical activity for children.

The article considers the features of the development and implementation of IT solutions (medical information systems) to improve the efficiency of procurement management of medical organizations in accordance with the current socio-economic situation and changing legislation. The author's experience of implementing a software product to optimize the implementation of the procurement process of medical devices is reflected/presented on the example of a specific regional medical organization.

The development of professional burnout in the employees of the organization is associated with a number of problems leading to a decrease in the human resource potential of the pharmacy organization and gradual loss of their market positions. The results of questionnaire survey of 50 employees of pharmacy organizations according to V. V. Boyko's methodology, which allows to determine the phases and symptoms of professional burnout, are presented. It was found that 62% of respondents have high and very high level of burnout. High prevalence of burnout among pharmacy employees shows the need to create organizational and socio-psychological measures for prevention and adaptation of professional burnout in pharmacy.

April 12, 2024 marks the 100th anniversary of the birth of Peter Josef Safar (1924—2003), an outstanding scientist, innovator, educator and humanist, three-time nominee for the Nobel Prize in Medicine. In the 1950s, Safar convinced everyone of the necessity of tilting the patient's head to eliminate tongue root retraction during mouth-to-mouth ventilations. Another significant but little-studied page of Peter Safire's biography is the development and implementation of the world's first ambulance service with a physician and volunteers trained in CPR. As a sign of respect for the merits of this talented man, the author has systematized analytical material about him and his activities and presented in a concise form, taking into account the assessments of leading domestic and foreign experts in the field of cardiopulmonary resuscitation, anesthesiology, disaster medicine and emergency conditions.

One of the main problems of drug provision is to maintain a balance between the needs of patients and the resource capabilities of the system, as well as the formation of the most effective strategy for their use. Increasing the availability of medicines to the population is carried out, among other things, through state price regulation. This paper examines changes in the list of vital and essential medicines (VED) approved by the Government of the Russian Federation for the purpose of state regulation of drug prices, in terms of INN, the volume of purchases of the VED segment and the dynamics of the average cost per package of VED in 2009 2023.

The accessibility of providing the population with narcotic analgesics in remote and hard-to-reach areas of three regions of Eastern Siberia — the Irkutsk region, the Republic of Buryatia and the Krasnoyarsk Territory — was studied. It has been established that the main reason is the low transport accessibility of the pharmacies in 23 (53%) areas with a population density of up to 5 people. per sq. km. The reduction in the number of municipal pharmacies in areas with low population in the Irkutsk region is being replaced by the involvement of privately owned joint-stock companies (25%) with a license for the circulation of NS and PV. The number of population per 1 pharmacy providing the population with narcotic and psychotropic drugs in the range of 45 thousand people was calculated. In the Irkutsk region. up to 41.2 thousand people in the Republic of Buryatia, which indicates common problems of increasing the availability of medicines in Eastern Siberia.

Despite the progress of modern medicine, at present, the problem of endocrine diseases is relevant for most countries of the world, and the Russian Federation is no exception. Official medical statistics data indicate the high medical and social importance of improving the system of providing medical care to the population in the field of endocrinology. In this regard, it becomes relevant to analyze the existing model of providing medical care to patients with endocrine pathology, existing world and domestic practices and scientific developments to improve the organization of medical care to the population according to the endocrinological profile. An analysis of the published scientific literature has shown that the existing system of providing medical care to patients with endocrine pathology, the level of organizational work on the ground to improve it, the pace of development do not adequately meet the increasing needs of the population of the Russian Federation and require a scientifically based reorganization of the endocrinological service and the reorientation of the entire healthcare system to a multi-level system of providing medical care to the population with endocrine diseases.

During the registration of cases of HIV infection, the leading route of infection changes from parenteral to sexual, which remains the leading route for most sexually transmitted infections. In turn, strictly sexually transmitted infections (STIs) continue to be the most effective risk factors for HIV infection. Identification of socially significant events among foreigners allows to support the epidemic process, which determines the venues and anti-epidemic measures, including deportation from the Russian Federation. The aim — present the epidemiological characteristics of STIs in combination with HIV infection, including among foreign citizens in the Republic of Tatarstan. Materials and methods. An analysis of information from official statistical reporting forms, as well as emergency notifications and maps of epidemiological investigations of STI and HIV infection cases for 2019—2023 was carried out. In addition, data from the state electronic information system of the Republic of Tatarstan was studied, including information about foreign citizens who arrived in the territory of the Republic of Tatarstan. The structure of detected infections in migrants undergoing medical examination at a skin and venereal disease dispensary was studied. The incidence of HIV infection among foreign citizens in the Republic of Tatarstan was analyzed taking into account differences in gender, age and country of origin of patients. Results. In 2023, compared to 2011, the incidence rate of STIs in the Republic of Tatarstan decreased from 466.7 to 129.7 cases per 100 thousand people. Cases of the disease were registered in all age categories, the largest number of which, up to 60%, occurred in persons aged 18—29 years, and up to 28% in persons aged 30—39 years. The epidemiological profile of co-infections with STIs in HIV-infected people is represented by the identification of a high percentage of cases of syphilis up to 45.5% of cases (max), gonorrhea (16.9%), trichomoniasis (34.7%), anogenital warts (36.2%), chlamydia (23.2%), urogenital herpes (11.8%). Over the analyzed 5-year period, 113 HIV-infected foreign citizens arrived in the republic, more than half of whom were men (79 people). The age structure of HIV-positive foreigners was dominated by migrants aged 30—39 (31.8%); 40—49 (24.8%), and 18—29 (23.9%) years old. 51 migrants (45%) of 113 HIV-infected people came from Uzbekistan.