REMEDIUM

This article presents a retrospective analysis of the formation and evolution of the organization of medical and social work with persons with disabilities in foreign societies. The study covers key historical stages in the development of assistance models — from antiquity to the present — and traces the transformation of approaches from religious and philanthropic practices to state-regulated and inclusive systems. A comparative-historical and systemic approach was applied, based on the analysis of academic literature, international legal frameworks, and practical models. Special attention is paid to the biopsychosocial model as the contemporary foundation for interdisciplinary disability support. The analysis highlights institutional development trends, the strengthening of legal frameworks for persons with disabilities, and the emergence of integrated rehabilitation strategies. The results of the study may be applied to enhance the Russian system of medical and social support through the adaptation of international best practices.

In the context of the digital transformation of healthcare, medical personnel are faced with the need to master digital competencies that ensure sustainable professional viability in a new clinical and organizational environment. The article presents a theoretical and analytical justification for the need to develop digital literacy of medical professionals, reveals the structure of digital competencies, including technical, informational, communicative, legal and reflexive components. The key reasons for the demand for digital skills in professional activities are analyzed: the implementation of the state policy of digitalization of healthcare, the growth of clinical information, the development of telemedicine, and the increase in digital activity of patients. Based on the analysis of statistical, regulatory and empirical sources, conclusions are formulated about the need for the institutional implementation of digital competencies in the system of training and support of medical personnel.

Primary health care is the foundation of the healthcare system of any country in the world. It is the quality of medical care available to the majority of the population that determines the health status of the population and is the best indicator of the level of social development of the country. The results of the study conducted by the authors demonstrate the level of patient satisfaction in three regions of the Russian Federation, which allows for a comparative analysis of the level of development of regional health systems in terms of their adequacy to patient expectations.

Technological advances in the field of medicine, which received an additional impetus to development during the COVID-19 pandemic, and subsequent organizational changes, increased requirements for high efficiency and quality of work of medical organizations, often continue to have a significant impact on the well-being of medical workers even after the pandemic in the absence of sound management. The work environment is a key factor determining the well-being and health of medical workers. Increasing the competence of managers in determining strategies for preventive solutions to the problem of an unfavorable working environment is the main condition for reducing the spread of professional burnout syndrome and personnel shortages in medicine. A well-structured work environment, organizational and communicative cultures of medical organizations and improved working conditions of medical workers are significant determinants of the effectiveness and quality of healthcare.

It is known that contact dermatitis is more common among healthcare workers than among the general population (21% versus 10%, respectively). The prevalence of occupational contact dermatitis among healthcare workers in recent years has ranged from 12% to 65%. The average prevalence of contact dermatitis of the hands among healthcare workers has increased to date from 21.08% to 37.24% due to the COVID-19 pandemic. This pathology, as one of the most common occupational skin diseases and a socially significant health problem, can lead to loss of productivity, sick leave, decreased quality of work and life, and decreased job satisfaction. In light of the global shortage of medical personnel, issues of occupational safety, monitoring of skin condition, and surveying healthcare workers about skin pathologies before hiring are relevant.

In the last decade, there has been a steady upward trend in the incidence of atopic dermatitis, a genetically determined inflammatory skin disease, among the child population. The inclusion of topical glucocorticosteroids in pediatric practice is justified, since these drugs control the symptoms of dermatological disease, reduce the risk of severe course of the pathological process. In the course of the work, a list of glucocorticosteroids for topical use presented in pharmacies of the metropolis was studied. An assessment of the range of drugs in this group revealed that the proposed drugs have a variety of release forms and a wide price range. A study of the ratio of imported and domestic drugs revealed that the main country producing the analyzed drugs is Russia. However, in the list of these pharmacies at the time of the study, an insufficient range of concentrations (weak, moderate or strong activity) of topical glucocorticosteroids was noted, indicated in clinical guidelines for the treatment of atopic dermatitis in children. Thus, it has been established that it is necessary to expand the range of glucocorticosteroids for topical use for pharmacotherapy of atopic dermatitis in children of different age groups.

In the article, research of the risks to the quality of medicines manufactured in pharmacies that may arise when using a burette unit is carried out. The risks are evaluated using the Ishikawa diagram method. As a result, it was found that due to a significant number of flaws when using the burette unit, its use is currently not advisable.

Pharmaceutical production is the leader in concluding contracts with counter investment obligations (offset contracts) among all industries. The bulk of contracts are concluded in Moscow, the largest regional market of medicinal products. The objective of the study was to determine the trends in structural changes in the Moscow pharmaceutical market after the start of deliveries under all offset contracts concluded at the beginning of April 2024. The study was based on the information from the official website of the Unified Information System in the Sphere of Procurement and data by DSM Group on medicinal products sales. The volume and structure of the market in the base period (2021) was compared with average annual supply figures under concluded offset contracts. In the period under review, 8 offset contracts were concluded in Moscow for the supply of drugs from 139 INN groups. In the base period the total supplies volume for 139 INNs under the regional programs of preferential drug provision, which are the focus of the offset contracts’ supplies, amounted to 13.4 billion rubles. According to the calculation model, as the result of offset contracts’ supplies, the total share of Russian manufacturers in the market of 139 INNs in the segment of the regional programs may increase from 16.6% to 63.6%, in the total government procurement market — from 23.5% to 45.8%, in the entire Moscow market (including retail sales) — from 18.6% to 31%. It was shown that already in the base period the share of Russian manufacturers was more than 90% in the segments of 24% INN, and more than 50% — in segments of 33% INN. In this regard, the advisability of further producers’ stimulation looks questionable, if we mean not attracting investments in the development of production in a specific region but achieving the goals of import substitution and maintaining competition in the public procurements of medicinal products in the all-Russian market. As a result of the implementation of the offset contracts’ supplies, with consideration of specific INN segments, a significant increase in domestic manufacturers’ share of the Moscow pharmaceutical market can be expected. At the same time, offset contracts’ supplies limit competition in the public procurement system with respect to other Russian manufacturers and create additional competitive advantages for attracting investment in Moscow preventing of the development of other regional pharmaceutical clusters.

Increasing the population's commitment to vaccination is a key task of the modern healthcare system, especially at the primary health care (PHC) level. Refusal of vaccinations or a low level of confidence in vaccine prevention threatens the sustainability of epidemiological well-being. The article analyzes modern information strategies aimed at increasing vaccination coverage, taking into account international and domestic experience. The most effective approaches to organizing information work have been identified, and the factors influencing the formation of behavioral attitudes towards vaccination have been identified.

The aim of the study was to determine the structure and trends of the public-private partnership projects market in the healthcare sector in the Russian Federation. The information and analytical base of the study was data on investment projects implemented on PPP principles and included in the register of the Rosinfra digital platform. Qualitative and quantitative research methods were used. The PPP market in the healthcare sector has been formed and is developing in different areas of industry activity. However, the analysis of the structure and trends showed its imbalance in models, legal forms, and areas of MP. Conditions have not been created for investors in socially significant areas — primary care, medical rehabilitation. The analysis of the structure and trends of the PPP market in the healthcare sector showed that it is necessary to develop mechanisms for attracting investments in the primary care (general therapeutic area) and improve special legislation in terms of PPP agreements in order to replicate infrastructure models in the industry. This will lead to a decrease in the number of low-capital-intensive and short-term projects, which will contribute to more sustainable development of PPP in the healthcare sector.