scholarly journals Oncology calculator as a tool for optimizing drug provision for patients with malignant neoplasms in the subjects of the Russian Federation

2021 ◽  
Vol 65 (5) ◽  
pp. 418-424
Author(s):  
Sergey A. Linnik ◽  
Elena E. Tumenko
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Clinical Guidelines ◽  
Federal Budget ◽  
Federal State ◽  
Malignant Neoplasms ◽  
Constituent Entity ◽  
Patients With Cancer ◽  
Number Of Patients ◽  
The Russian Federation

Introduction. The increase in financial resources on the part of the state for the procurement of medicines for treating patients with malignant neoplasms makes the issue of calculation the need in medicinal preparations (MP) actual. The aim of the work is to develop a special tool (oncology calculator) that standardizes the method for determining the need for drugs and can calculate the need for medications for the treatment of malignant neoplasms in a particular constituent entity of the Russian Federation. Material and methods. To develop an oncology calculator, we analyzed the need for the drugs for the treatment of patients with the most common malignant neoplasms was analyzed based on current clinical guidelines approved and published on the Ministry of the Russian Federation website. The number of patients at each stage of a specific cancer was calculated. The frequency of application of a particular treatment regimen was calculated based on the approved standards of medical care for patients with cancer or from a project. The number of patients was calculated on the official statistics presented in the P.A. Hertsen Moscow Oncological Research Institute - branch of the Federal State Budgetary Institution “National Medical Research Center of Radiology” by the Ministry of Health of Russia. Results. We have developed a tool called the “Oncology calculator” that standardizes the methodology for determining the need of a constituent entity of the Russian Federation or a medical institution for drugs based on clinical guidelines, as well as facilitating the planning of the volume of medical care in the conditions of round-the-clock and day hospitals, and in the provision of medical care to patients with malignant neoplasms in outpatient settings. Conclusion. The existing approaches to calculating the need for drugs for the treatment of patients with cancer in the constituent entities of the Russian Federation are scattered, which leads to the ineffective use of funds from the federal budget, compulsory medical insurance funds, budgets of the constituent entities of the Russian Federation. A uniform approach to calculating the need for drugs to treat malignant neoplasms should be based on clinical guidelines containing drug regimens for treating patients.

scholarly journals Analysis of the availability and direction of improvement of medical care for patients with malignant neoplasms in the Moscow region

2018 ◽  
Vol 5 (4) ◽  
pp. 106-117
Author(s):  
E. Yu. Ogneva ◽  
A. N. Gurov ◽  
M. V. Pirogov ◽  
E. V. Gameeva ◽  
O. Yu. Aleksandrova
Keyword(s):  
Medical Care ◽  
Cancer Patients ◽  
Russian Federation ◽  
Federal District ◽  
Moscow Region ◽  
High Tech ◽  
Malignant Neoplasms ◽  
Patients With Cancer ◽  
The Subject ◽  
The Russian Federation

Purpose. Carrying out medical and statistical analysis of morbidity and mortality of the population with malignant neoplasms, development of proposals for greater accessibility and areas of improvement of specialized including high-tech medical care (HTMC) for patients with cancer in the Moscow region.Materials and methods. The analysis of morbidity and mortality of the population of the Moscow region from malignant neoplasms and the organization of specialized, including high-tech, medical care to cancer patients on the basis of forms of Federal state statistical observations in relation to the three-level system of the organization of medical care to the population of the region with identification of organizational and financial problems.Results. The incidence of malignant neoplasms in the Moscow region in 2017 amounted to 364.9 per 100 thousand population, which is 1.0% below the level of 2016-365.9 per 100 thousand population and below the average for the Central Federal district and the Russian Federation. The mortality rate from neoplasms in the Moscow region decreased in 2017 to 174.7 cases per 100 thousand population, which is less than the average for the Central Federal district — 207.1 and the Russian Federation — 196.9 per 100 thousand population. At the same time, the volume of specialized medical care (including high — tech medical care) for malignant tumors, in a 24-hour hospital is more than twice the average Russian standard — 13% for SMC and 50% for HTMC. Exceeding the standard of medical care is mainly due to the HTMC 2, which is not planned in the subject of the Russian Federation and is usually in Federal clinics. The share of oncological medical care received outside the medical organizations of the MR is 16%, which exceeds the share of medical care in all other profiles received outside the Moscow region (12%). This situation contributes to the availability of cancer care to the population of the Moscow region.Conclusion. The performed work allowed to draw conclusions that in normative legal acts of Federal level it is necessary to define separately the standard of volumes of specialized, including hi-tech medical care, on the profile of Oncology. Large volumes of HTMC cannot be an unambiguous characteristic of the availability of medical care in General, since HTMC is medical care with the use of complex methods of diagnosis and treatment in clinically complex cases. Large volumes of HTMC can be a consequence of the complexity of clinical cases, but also a consequence of neglect of the disease due to the lack of diagnosis and treatment in the provision of primary health care (PHC) at the 1st level. In the Moscow region, there is a need to redistribute the volume of this medical care not only to cancer dispensaries, but also to other medical organizations. After that, there is a need for the distribution of patients, taking into account the morbidity in the territories, the place of residence of citizens, and taking into account the capabilities of medical organizations for the treatment of cancer patients (surgical treatment, chemotherapy, radiotherapy). Medical organizations of the subject of the Federation shall be ranked taking into account the applied technologies and opportunities of drug therapy. As a result, a clear routing of patients with cancer should be developed in the subject of the Russian Federation.

Review of clinical guidelines “Cystic fibrosis”, 2020

2021 ◽  
Vol 31 (2) ◽  
pp. 135-146
Author(s):  
E. I. Kondratyeva ◽  
E. L. Amelina ◽  
M. Yu. Chernukha ◽  
V. D. Sherman ◽  
S. A. Krasovskiy ◽  
...  
Keyword(s):  
Health Care ◽  
Cystic Fibrosis ◽  
Medical Care ◽  
Russian Federation ◽  
Clinical Guidelines ◽  
Health Care Services ◽  
Diagnostic Tools ◽  
Federal State ◽  
Diagnostic Strategy ◽  
The Russian Federation

The aim of the experts who provide health care for patients with cystic fibrosis (CF) has been to develop clinical guidelines on cystic fibrosis for children and adults.Methods. The 2020 Clinical Guidelines were based on the European consensus documents on cystic fibrosis and the national consensus “Cystic fibrosis: definition, diagnostic criteria, therapy” (2016, 2019). When creating clinical guidelines, the experts were guided by Article 2 of the Federal Law No.323-FL “On the basics of health care in the Russian Federation” as of November 21st, 2011, and the regulatory legal documents governing the development and approval of clinical guidelines (https://rosmedex.ru/kr/).Results. The clinical guidelines were approved by the Federal State Budgetary Institution “Centre for Expertise and Quality Control of Medical Care” of the Russian Ministry of Health in August 2020. Standards of medical care for children and adults with cystic fibrosis were prepared based on these guidelines. The diagnostic algorithms have been expanded with a three-stage DNA diagnostic strategy, functional assays of CFTR channel, laboratory and instrumental diagnostic tools for assessing disorders of respiratory and other systems, diagnosis of the microbial inflammatory process, microbiological monitoring, and therapeutic approaches. The antibiotic therapy with dosages and courses is described in detail. The updated document should describe a unified tactic for the management of Russian CF patients.Conclusion. Unified clinical guidelines for children and adults should develop unified tactics for the diagnosis, therapy, and follow-up of CF patients in the Russian Federation and ensure continuity between health care services for children and adults.

scholarly journals Primary hyperparathyroidism in Russia according to the registry

2019 ◽  
Vol 65 (5) ◽  
pp. 300-310 ◽  
Author(s):  
Natalya G. Mokrysheva ◽  
Svetlana S. Mirnaya ◽  
Ekaterina A. Dobreva ◽  
Irina S. Maganeva ◽  
Elena V. Kovaleva ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Primary Hyperparathyroidism ◽  
Medical Care ◽  
Russian Federation ◽  
Parathyroid Carcinoma ◽  
Large Scale ◽  
Active Phase ◽  
Symptomatic Disease ◽  
Number Of Patients ◽  
The Russian Federation

BACKGROUND: There are no large-scale epidemiological studies on primary hyperparathyroidism (PHPT) in Russia. The high prevalence of the disease, the high risk of disability and death in this cohort of patients requires the study of the epidemiological and clinical structure of PHPT to determine the extent of medical care. AIM: Evaluate the frequency of PHPT detection and characterize its clinical forms in Russia using an online registry. METHODS: The object of the study is the database of the State Register of Patients with PHPT 1914 patients from 71 regions of the Russian Federation. New cases of the disease, as well as dynamic indicators are recorded when patients visit outpatient clinics or medical institutions. The analysis of data made at the end of December 2017 was carried out. The following parameters were evaluated: demographic and clinical indicators; indicators of phosphorus-calcium metabolism, the main forms of PHPT and its course, the primary characteristic of PHPT in hereditary syndromes and parathyroid carcinoma. Results are presented as mean and standard deviations, or medians and quartiles; descriptive statistics of qualitative attributes absolute and relative frequencies. RESULTS: the total number of patients with PHPT in the registry on 31 of December 2017 was 1914 cases (0.001% of the population of the Russian Federation). Identification of PHPT was 1.3 cases per 100 thousand of the population in Russia, 7.6 cases in Moscow, 6.1 cases per 100 thousand in the Moscow region. The average age of patients at the time of diagnosis was 55.6 10 years. The active phase of the disease was registered in 84.6% of patients (1620/1914), most of whom had a symptomatic PHPT 67.1% (1087/1620), and 32.9% a asymptomatic disease (533/1620). Symptomatic disease with visceral complications was detected in 15.8% cases (172/1087), with bone complications in 48.4% (526/1087). The mixed form of the disease was detected in 35.8% of patients with manifest form (389/1087). Normocalcemic variant PHPT (nPHPT) was registered in 14.5% cases (234/1620). Sporadic PHPT occurs in 83% of cases (1592/1914). 326 patients (17%) had a suspicion for hereditary form of the disease: average age was 31.2 12.3 years. A genetic analysis was conducted in 61 patients (3.2%): showed the mutation in the MEN1 gene in 2.9% of cases (55/1914) and the mutation in the CDC73 gene in 0.3% of cases (6/1914) (HPT-JT syndrome). Parathyroid carcinoma was confirmed in 1.8% of all patients (35/1914). Surgical treatment was performed in 64.5% of patients (1234/1914). Remission was achieved in 94% of cases (1160/1234), in 6% of cases relapse after surgical treatment or persistence of PHPT was recorded. CONCLUSION: detection of PHPT in the Russian Federation raised in comparison to 2016, which is associated with an active start of registration of patients in the regions. At this stage, it is necessary to modify the principles of registration and control, to make a platform for gathering information and calculating the necessary volumes of medical care for PHPT patients.

scholarly journals Treatment of patients with malignant lymphoproliferative diseases in the Russian Federation: analysis of the data from 75 regions

2019 ◽  
Vol 11 (4) ◽  
pp. 3-15
Author(s):  
G. R. Hachatryan ◽  
T. S. Teptsova ◽  
V. A. Lemeshko ◽  
N. Z. Musina
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
High Tech ◽  
Lymphoproliferative Diseases ◽  
Number Of Patients ◽  
Icd 10 ◽  
The Russian Federation ◽  
Specialized Institutions

The aimis to analyze the medical records of patients with malignant lymphoproliferative diseases (LPD) in the Russian Federation in 2016- 2017.Materials and methods. Treating physicians in 75 regions of the Russian Federation were asked to fill the survey questionnaire containing 9 types of malignant LPDs (according to the ICD-10 classification). The questions covered the epidemiology of LPD (prevalence, resistant forms, relapses and mortality), the existence of specialized institutions and beds, the costs of medical care in patients with malignant LPD, and the financial support of pharmacotherapy in these patients during their hospital stay.Results. We found that the most common malignant LPD in 2016-2017 was Hodgkin’s lymphoma (73.5 and 73.4%, respectively). The prevalence of resistant forms and recurrences of malignant LPD over this period accounted for 6.8% of the total patient population. In 2017, the number of patients who died was 7.5% less than that in 2016. There are 815 and 1,763 specialized institutions of the oncology and hematology profiles that provide medical care to children and adult patients, respectively. Among the malignant LPDs, the highest costs of drug therapy in 2016 pertained to lymphosarcoma, and in 2017 – to Hodgkin’s lymphoma. In the system of compulsory health insurance (OMC), the largest spending for both adult and pediatric patients in 2016 and 2017 was accounted for Hodgkin’s lymphoma; a similar result was obtained for the cost of therapy based on high-tech medical care.Conclusion. In 2017, the total number of patients with malignant LPD in the Russian Federation increased by 2.65% as compared to 2016, while the proportion of primary LPD decreased by 1.2%. In 2017, the total costs of drug supply in patients with malignant LPD in the RF increased by 55.35% as compared with 2016.

The evaluation of epidemiology and the availability of medical care for patients with retina diseases in the Russian Federation

2020 ◽  
pp. 26-36
Author(s):  
I. V. Laricheva ◽  
◽  
I. M. Son ◽  
E. S. Yastrebova ◽  
V. V. Neroev ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Macular Degeneration ◽  
Russian Federation ◽  
Vision Loss ◽  
Age Related Macular Degeneration ◽  
Complete Evaluation ◽  
Age Related ◽  
Number Of Patients ◽  
The Russian Federation

Retinal diseases are significant causes of blindness and vision loss and they take the second place in the structure of disabilities due to blindness in Russia. Objective: analysis of the official statistical data on the disease and availability of health care to patients with age-related macular degeneration (AMD) and diabetic retinopathy (DR) that are prescribed intravitreal injection of drugs (IVD) as the first-line therapy for wet age-related macular degeneration and diabetic macular edema, respectively. Materials and methods: Epidemiological parameters were assessed by the data obtained from the form of statistical records № 12 for 2018–2019 years. The availability of IVD was analyzed by the information registered in the form of statistical records № 14 for 2016–2019 with a recalculation per 1000 population. Results: In 2019 in the Russian Federation 330 thousand patients with AMD were registered (0.45% among the population older than 40 years old). The incidence rate was significantly lower than in other countries (8.69%). The data on the number of patients with DR was unavailable for statistical recording because of the absence of the code Н36.0 IDC‑10 in form № 12. However, according to the federal register of diabetes mellitus, the total rate of DR can reach 760 thousand people all over Russia. The availability of IVD for all-day inpatient health care was 0.39 injections per 1000 population. In 26 subjects of the Russian Federation, the availability was higher than the average in Russia, while in the rest 59 subjects, the availability was lower than the average. Presently, there are no data on the number of IVD performed in day-time inpatient facilities. Conclusions: The current rate of application of IVD in Russia can be estimated as low considering the revealed problems with the registration and accounting of patients with AMD and DR. It is impossible to perform a complete evaluation of the availability of IVD for the Russian population within obligatory medical health insurance because of the lack of data on the provision of IVD in day-time inpatient facilities. For the rational planning of the volumes of medical care provision to patients with AMD and DR, the form of statistical records should include the data on the indication of IVD in the day-time inpatient facilities in the subjects of the Russian Federation.

scholarly journals Incidence of malignant neoplasms at radiation-hazardous facilities

2021 ◽  
Vol 100 (2) ◽  
pp. 154-158
Author(s):  
Aleksandr P. Biryukov ◽  
El’vira P. Korovkina ◽  
Igor’ P. Korenkov ◽  
Aleksandr R. Tukov ◽  
Sergej E. Okhrimenko ◽  
...  
Keyword(s):  
Russian Federation ◽  
Age Groups ◽  
Federal State ◽  
Malignant Neoplasms ◽  
Social Rehabilitation ◽  
Present Information ◽  
Icd 10 ◽  
Personal Level ◽  
The Russian Federation ◽  
Annual Mortality

Introduction. Authors present information on the results of social and hygienic monitoring of personnel’s health status at hazardous radiation facilities and the assigned contingent of healthcare institutions of Russia’s FMBA. The main causal patterns of the influence of risk factors on morbidity and mortality from malignant neoplasms (MNO) among employees of enterprises and the attached contingent of organizations served by healthcare institutions of the FMBA of Russia were revealed. Material and methods. The object of the study was the data on malignant neoplasms obtained from the Federal State Budgetary Institution FTSITEP FMBA of Russia and the Branch Medical and Dosimetric Register of the A.I. Burnazyan FMBA of Russia for 2012-2016. Comparative data of official medical statistics on the incidence of malignant neoplasms and mortality from them in the contingent served by FMBA hospitals, according to the nosological forms of ICD-10 and age groups with similar indices in Russia as a whole, were studied and analyzed (“NMITs Radiology” of the Ministry of Health of Russia). Results. An increase in the incidence of malignant neoplasms in Russia’s FMBA for 2012-2016 (328.4-359.6) and the Russian Federation (367.3-408.6) was noted. 9, which is significantly less than the all-Russian indices (201.0-201.6). The annual mortality rate in 2016 was lower in Russia’s FMBA patients (17.7%) than in the Russian Federation (23.3%). The five-year survival rate in Russia’s FMBA was close to that in the Russian Federation (49.9-54.3%.) It was noted that the largest number of cancer cases was observed in the older age groups: 40-59 years: 23.3-26.6%; 60-85 years: 72.2-68.3%, the same as in the Russian Federation. Conclusion. The research results can become the basis for the development of measures for medical and social rehabilitation of employees of enterprises and organizations served by medical and preventive institutions of the FMBA of Russia and the assigned contingent. In the area of the location of hazardous radiation facilities, constant monitoring and analysis of indicators of cancer incidence, carried out at a personal level using register technologies, is required.

scholarly journals SEGMENTATION OF TERRITORIES OF THE REPUBLIC OF BASHKORTOSTAN ON THE LEVEL OF MORTALITY FROM MALIGNANT NEOPLASMS

2019 ◽  
Vol 63 (1) ◽  
pp. 4-13
Author(s):  
P. A. Askarov ◽  
A. O. Karelin ◽  
I. A. Lakman ◽  
L. F. Rozanova ◽  
Zagira F. Askarova
Keyword(s):  
Cluster Analysis ◽  
Russian Federation ◽  
Malignant Tumors ◽  
Mortality Rates ◽  
Federal State ◽  
Malignant Neoplasms ◽  
Actual Problem ◽  
Republic Of Bashkortostan ◽  
The Russian Federation ◽  
The Republic

Malignant neoplasms are an actual problem due to their high prevalence, high level of disability, tendency to increase. The purpose of the study is the segmentation of the territories of the Republic of Bashkortostan (RB) by the level of mortality from malignant neoplasms (MN) as a whole by municipalities, as well as by gender and by localizations of malignant neoplasms. Material and methods. The data of official statistics of the Territorial body of the Federal State Statistics Service of the Republic of Belarus (Table C 51), Rosstat were analyzed. The study was conducted using k-means cluster analysis and rating, implemented in the Statistica system. Results. There is a significant increase in the death rate of the entire population of ZN in 41 municipalities. Analysis of standardized mortality rates shows that the mortality rate per 100 thousand of the population in the Republic of Belarus is lower than similar indicators in the Russian Federation. The exception is mortality in esophageal cancer, which is higher in both men and women than in the Russian Federation. It has been established that the regions of the fourth and fifth clusters are unfavorable in terms of mortality from MN. Discussion. Revealed a pronounced uneven distribution of the territory of the Republic of Belarus with a tendency to an increase in mortality from MN in many territories. It is possible that the main reasons for the increase in mortality rates are worsening socio-economic conditions, lower living standards, increased chemical stress in urbanized areas (air pollution), as well as insufficient promotion of healthy lifestyles among the population, preventive knowledge, and health problems. care, its poor quality. Conclusion. As a result of the analysis, it was possible to establish that cluster analysis allows us to identify areas that have similar problems related to the level and trends of mortality from malignant tumors.

scholarly journals Routing of aero-medical evacuation in the regions of the Russian Federation

2020 ◽  
pp. 69-75
Author(s):  
I. V. Isaeva
Keyword(s):  
Public Health ◽  
Medical Care ◽  
Russian Federation ◽  
Disaster Medicine ◽  
Golden Hour ◽  
Medical Evacuation ◽  
Health Authorities ◽  
Number Of Patients ◽  
The Russian Federation ◽  
Access To Medical Care

Relevance. In accordance with the Decree N 254 of the President of the Russian Federation dated June 06, 2019 “About strategy of the public health development in the Russian Federation up to the year 2025”, one of the primary challenges of public health is providing access to medical care for every citizen irrespective of his/her location in the country. Patients with life-threatening acute conditions should get emergency medical care within so-called “golden hour”, with selecting optimal routes to the appropriate specialized medical centres as soon as possible. In Russia, this can be realized only via air medical evacuation.Intention. To assess an existing routing system based on the aero-medical evacuation in the regions of the Russian Federation, both under emergency and routine conditions.Methodology. Reports of the Territorial Centres for Disaster Medicine and health authorities of the entities of the Russian Federation were studied.Results and Analysis. Standard locations of the capitals of the Russian Federation entities are described, along with need to cooperate with adjacent regions for evacuating patients both routinely and in case of emergencies. Trends and options of air medical transportation are prioritized to minimize risks of health deterioration in patients and casualties. The study showed increase in the number of patients evacuated via air transportation. Control over routing during medical evacuation of injured in emergencies can reduce the mortality rate due to transporting them to specialized medical centers.Conclusion. Aero-medical transport is extremely demanded for evacuating the injured in emergencies to interregional and federal medical centres.

scholarly journals Regulatory framework of the oncological medical care provision

2020 ◽  
Vol 13 (3) ◽  
pp. 304-315
Author(s):  
S. N. Tishkina ◽  
V. E. Matskevich ◽  
Yu. A. Ledovskikh ◽  
E. V. Semakova ◽  
V. V. Omelyanovskiy
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Clinical Guidelines ◽  
Financial Support ◽  
Legal Framework ◽  
Regulatory Documents ◽  
Analytical Review ◽  
The Russian Federation ◽  
The Government ◽  
Guidelines And Standards

Aim. To conduct an analytical review of the regulatory legal framework on the resources provision required in medical organizations for the provision of oncological medical care based on clinical guidelines.Materials and methods. Using Russian normative legal and regulative documents on the oncological medical care, the authors studied the normative regulation of the issues of both resources’ provision for medical organizations and resources’ demand assessment, including the need for financial support from various sources of the budgetary system of the Russian Federation. The analysis was carried out in two regulatory areas: financing and organization of the provision of medical care. The authors examined the main legislation acts relating to oncological medical care, including documents of the compulsory medical insurance, the annual decrees of the Government of the Russian Federation on the program of state guarantees of free provision of medical care to citizens for the coming year and the planned period, the decree of the Government of the Russian Federation regulating the provision of medicines and medical products, provisions on the organization of medical care by type of medical care, procedures for the provision of oncological medical care, regulatory documents on clinical guidelines and standards of medical care.Results. The content analysis of the studied materials showed that certain components of the resources’ provision, including the financial provision of oncological medical care, are regulated by various regulatory documents, and there is no methodology for assessing the resources’ demand based on clinical guidelines.Conclusion. New approaches to assessing the resources’ demand for the provision of medical care and the required financial support based on clinical guidelines need to be developed.

Analysis of the level and structure of the incidence of the population of the KHMAO

2021 ◽  
Vol 22 (3) ◽  
pp. 82-89
Author(s):  
T. V. Razumova ◽  
◽  
T. V. Zuyevskaya ◽  
P. I. Pavlov ◽  
E. V. Sadrieva ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Russian Federation ◽  
Age Groups ◽  
Circulatory System ◽  
Federal District ◽  
Malignant Neoplasms ◽  
Number Of Patients ◽  
Working Age ◽  
The Russian Federation ◽  
Khanty Mansi Autonomous

Purpose of the study: assessment of the level and structure of the incidence of the population to determine the main categories of diseases most common in the Khanty-Mansi Autonomous Okrug-Yugra, as well as making a territorial comparison of the incidence of the population. Materials and research methods: statistical materials from the annual collection “Health of the population of the Khanty-Mansi Autonomous Okrug-Yugra and the activities of medical organizations” and data of statistical reporting on the incidence of the population from the Medstat program were used, in particular, the primary morbidity of the population of the Khanty-Mansi Autonomous Okrug-Yugra in different age groups, the general incidence the population of different age groups of the Khanty-Mansi Autonomous Okrug-Yugra. The analysis used indicators such as primary morbidity, general morbidity, one-year mortality (died within the first year from the date of diagnosis) in malignant neoplasms. Results. The primary morbidity of the population in the Khanty-Mansi Autonomous Okrug-Yugra tends to grow in all age groups. The indicators of primary morbidity of the population of the Khanty-Mansi Autonomous Okrug-Yugra in 2018 are 17.1% higher than in the Russian Federation and 12.2% higher than in the Ural Federal District. In the structure of primary morbidity, the first place is taken by diseases of the respiratory system, the second place in the structure of the primary morbidity of people over working age is taken by diseases of the circulatory system, and the third place is by diseases of the genitourinary system. The overall incidence rate of the entire population is 1896 per 1000 population. In 2018, 41.2 cases of tuberculosis per 100 thousand of the population were detected for the first time in the Khanty-Mansi Autonomous Okrug-Yugra (in the Ural Federal District – 61.6, in the Russian Federation – 44.4 per 100 thousand of the population). This pathology tends to decrease and compared with 2017 decreased by 10.2% (the Russian Federation decreased by 8.1%, the Ural Federal District – 2.1%). The number of patients with newly diagnosed HIV infection in 2018 decreased by 1.5% compared to 2017 and amounted to 82.3 per 100 thousand population, which is higher than in the Russian Federation (58.5), but lower. than in the Ural Federal District (108.2) per 100 thousand population. Since 2012, there has been a tendency towards an increase in the incidence of malignant neoplasms, but the detection rate of malignant neoplasms at stages III-IV has not changed since 2015 and is 39.5%, which is higher than in the Russian Federation (38.5%). Conclusion: the primary morbidity in the Khanty-Mansi Autonomous Okrug-Yugra in 2018 is 17.1% higher than in the Russian Federation. In the first place are diseases of the respiratory system (48.4%, of which in children – 66.4, and in persons of older working age – 22.2%). In second place in children is infectious pathology, and in people of working age – diseases of the genitourinary system. The second place in morbidity in older people of working age is diseases of the circulatory system. The district has a high level of infectious and parasitic diseases. The number of patients with newly diagnosed tuberculosis is lower than in the Ural Federal District and the Russian Federation. The number of patients with HIV infection is higher than in the Russian Federation, but lower than in the Ural Federal District. There is a tendency towards an increase in the number of malignant neoplasms. The number of neoplasms is lower than in the Ural Federal District and the Russian Federation. In the Khanty-Mansi Autonomous Okrug-Yugra, there is a positive trend in the reduction of socially significant diseases, such as tuberculosis, HIV infection, STIs, alcoholism, drug addiction, injuries and an increase in overall morbidity, including malignant neoplasms, which indicates the availability of medical care, health literacy of the population and carrying out appropriate preventive work.

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