2024
2023
2022
2021
2020
2019
2018
Effectiveness of the Federal project “Fight against cardiovascular diseases” in the context of preventable causes of death in the Russian urban and rural settlements
ru
Original Article|Public Management and Public Administration
AbstractFull textReferencesFilesAuthorsAltmetrics
Federal Center of Theoretical and Applied Sociology of the Russian Academy of Sciences (6/1, Fotieva St., Moscow, 119333, Russian Federation)
Aleksandr V. Zubko (Cand. Sci. (Medicine))
Federal Center of Theoretical and Applied Sociology of the Russian Academy of Sciences (6/1, Fotieva St., Moscow, 119333, Russian Federation)
Viktoriya G. Semyonova (Dr. Sci. (Economics))
Federal Center of Theoretical and Applied Sociology of the Russian Academy of Sciences (6/1, Fotieva St., Moscow, 119333, Russian Federation)
Introduction. In 2019, within the framework of the National project “Healthcare”, a Federal project “Fight against Cardiovascular Diseases” was launched to reduce mortality from heart attack, stroke and other vascular disorders by a quarter by 2024, predominantly among the Russian working population. For the health policy measures in the field of cardiovascular diseases to be successfully implemented, activities stipulated by the Federal project should be revised and updated and target indicators reassessed with due regard to the current situation. Another important managerial aspect is the overall project performance assessment in the context of the COVID-19 pandemic, which is associated with a significant increase in cardiovascular mortality.
Material and methods. The Russian mortality among population aged 5-64 in 2003-2021 was analyzed identifying periods of rapid and slow mortality reduction (2005-2013, 2013-2019) as well as the pandemic period (2019-2021). Comparative analysis was conducted by gender, preventable and unavoidable death, urban and rural settlements.
Results. Generally, dynamics in mortality from diseases of the circulatory system among population aged 5-64 is similar to the one in preventable mortality: the correlation coefficient in 1999-2021 equaled to 0.984 in males and 0.998 in females. From the beginning of the century and up to 2019, the contribution of male cardiovascular mortality to the total mortality hardly changed (37.3% in 2003 and 35.5% in 2019), while in females it decreased from 38.6% in 2003 to 29.3% in 2019. By 2021, it has decreased to 32.2% and 23.5%, respectively.
Discussion. Improvements in quality of medical care can be evidenced by the decreased share of acute cardiovascular events in the structure of mortality from coronary heart disease. The use of the preventable mortality concept regarding diseases of the circulatory system makes it possible to evaluate effectiveness and develop practical recommendations for further mortality reduction, which fully corresponds to the entire process of increasing management efficiency.
Conclusions. The study results show that the concept of preventable mortality is applicable to “Diseases of the circulatory system”; the technique allows for more in-depth analysis results regarding the impact of cardiovascular risk factors, which can serve as an evidence base to assess project performance in the field of fighting cardiovascular diseases. The use of this technique makes it possible to track improvements in diagnostic capabilities, access to and quality of medical care, despite the fact that the improved socio-economic well-being and preventive activities to reduce behavioral risk factors remain the main contributors to the decreased mortality from diseases of the circulatory system.
Material and methods. The Russian mortality among population aged 5-64 in 2003-2021 was analyzed identifying periods of rapid and slow mortality reduction (2005-2013, 2013-2019) as well as the pandemic period (2019-2021). Comparative analysis was conducted by gender, preventable and unavoidable death, urban and rural settlements.
Results. Generally, dynamics in mortality from diseases of the circulatory system among population aged 5-64 is similar to the one in preventable mortality: the correlation coefficient in 1999-2021 equaled to 0.984 in males and 0.998 in females. From the beginning of the century and up to 2019, the contribution of male cardiovascular mortality to the total mortality hardly changed (37.3% in 2003 and 35.5% in 2019), while in females it decreased from 38.6% in 2003 to 29.3% in 2019. By 2021, it has decreased to 32.2% and 23.5%, respectively.
Discussion. Improvements in quality of medical care can be evidenced by the decreased share of acute cardiovascular events in the structure of mortality from coronary heart disease. The use of the preventable mortality concept regarding diseases of the circulatory system makes it possible to evaluate effectiveness and develop practical recommendations for further mortality reduction, which fully corresponds to the entire process of increasing management efficiency.
Conclusions. The study results show that the concept of preventable mortality is applicable to “Diseases of the circulatory system”; the technique allows for more in-depth analysis results regarding the impact of cardiovascular risk factors, which can serve as an evidence base to assess project performance in the field of fighting cardiovascular diseases. The use of this technique makes it possible to track improvements in diagnostic capabilities, access to and quality of medical care, despite the fact that the improved socio-economic well-being and preventive activities to reduce behavioral risk factors remain the main contributors to the decreased mortality from diseases of the circulatory system.
Keywords: controllable death causes, mortality prevention levels, healthcare performance indicators, mortality growth rate, cardiovascular mortality, federal project efficiency
УДК: 314.4:614.2
ВАК: 05.02.06, 03.02.03, 05.04.03
ГРНТИ: 05.11.61, 05.11.91
Article received: February 27, 2023
Article accepted: April 21, 2023
Yarmonova, M. V., Chaykina, N. N., & Yarmonov, S. N. (2022). On the incidence of cardiovascular diseases and ways of its prevention at the regional level. The Scientific Heritage, (82-2), 45–48. https://doi.org/10.24412/9215-0365-2022-82-2-45-48.
Bulanova, M. A. (2022). Assessment of the impact of demographic policy to reduce mortality (using the example of the Far-Eastern federal district). Power and Management in the East of Russia, (1), 60–75. https://doi.org/10.22394/1B1B-4049-2022-9B-1-60-75.
Carstensen, B. (1989). European community atlas of ‘avoidable death’ (Book review). Statistics in Medicine, 8(5), 635–635. https://doi.org/10.1002/sim.4780080513.
Westerling, R. (2001). Commentary: Evaluating avoidable mortality in developing countries – an important issue for public health. International Journal of Epidemiology, 30(5), 973–975. https://doi.org/10.1093/ije/30.5.973.
Treurniet, H. F. (2004). Avoidable mortality in Europe (1980-1997): A comparison of trends. Journal of Epidemiology & Community Health, 58(4), 290–295. https://doi.org/10.1136/jech.2002.006452.
Westerling, R., Gullberg, A., & Rosén, M. (1996). Socioeconomic differences in ‘avoidable' mortality in Sweden 1986-1990. International Journal of Epidemiology, 25(3), 560–567. https://doi.org/10.1093/ije/25.3.560.
Nolte, E. (2003). Measuring the health of nations: Analysis of mortality amenable to health care. BMJ = British Medical Journal, 327(7424), Article 1129. https://doi.org/10.1136/bmj.327.7424.1129.
Simonato, L., Ballard, T., Bellini, P., & Winkelmann, R. (1998). Avoidable mortality in Europe 1955-1994: A plea for prevention. Journal of Epidemiology & Community Health, 52(10), 624–630. https://doi.org/10.1136/jech.52.10.624.
Tobias, M., & Yeh, L. (2009). How much does health care contribute to health gain and to health inequality? Trends in amenable mortality in New Zealand 1981-2004. Australian and New Zealand Journal of Public Health, 33(1), 70–78. https://doi.org/10.1111/j.1753-6405.2009.00342.x.
Santos-Jaén, J. M., León-Gómez, A., Valls Martínez, M. del C., & Gimeno-Arias, F. (2022). The effect of public healthcare expenditure on the reduction in mortality rates caused by unhealthy habits among the population. Healthcare, 10(11), Article 2253. https://doi.org/10.3390/healthcare10112253.
Valls Martínez, M. (2019). Patient satisfaction in the Spanish national health service: Partial least squares structural equation modeling. International Journal of Environmental Research and Public Health, 16(24), Article 4886. https://doi.org/10.3390/ijerph16244886.
Ramírez-Orellana, A., del Carmen Valls Martínez, M., & Grasso, M. S. (2021). Using higher-order constructs to estimate health-disease status: The effect of health system performance and sustainability. Mathematics, 9(11), Article 1228. https://doi.org/10.3390/math9111228.
Korda, R. J., & Butler, J. R. G. (2006). Effect of healthcare on mortality: Trends in avoidable mortality in Australia and comparisons with Western Europe. Public Health, 120(2), 95–105. https://doi.org/10.1016/j.puhe.2005.07.006.
Favaloro, R.G. (1968). Saphenous vein autograft replacement of severe segmental coronary artery occlusion: Operative technique. The Annals of Thoracic Surgery, (5), 334–339. https://doi.org/10.1016/S0003-4975(10)66351-5.
Zubko, A. V., & Sabgayda, T. P. (2016). Vascular surgery in hospitals of different levels. Social Aspects of Population Health, (6), Article 2. https://elibrary.ru/xeptcb.
Galimzyanov, A. F., Garipov, R. Z., & Sleyter, M. (2021). Special software for management of risk factors for cardiovascular diseases. Medical Bulletin of the Ministry of Internal Affairs, (1), 70–74. https://elibrary.ru/lritxg.
Ivanova, A. E., Golovenkin, S. E., & Mikhaylov, A. Yu. (2014). Evaluating effectiveness of policy measures aimed at reducing mortality from cardiovascular diseases. Social Aspects of Population Health, (3), Article 1. https://elibrary.ru/sinaih.
Zheleznyak, N. L., Boyushenko, E. N., Panov, A. V., & Tanova, A. A. (2020). Medical and statistical analysis of indicators of the implementation of the regional project “Combating cardiovascular diseases”. Glavnyi Vrach Uga Russia, (4), 9–12. https://elibrary.ru/tzygmp.
Dmitrieva, T. B., & Drozdov, A. Z. (2010). Sex and gender aspects of stress resistance: Analytical review (Part 1). Russian Journal of Psychiatry, (1), 18–24. https://elibrary.ru/ndsxpr.
Westerling, R. (2003). Decreasing gender differences in “avoidable” mortality in Sweden. Scandinavian Journal of Public Health, 31(5), 342–349. https://doi.org/10.1177/14034948030310050201.
Chen, C., Zhou, Y., & Wang, D. W. (2020). SARS-CoV-2: A potential novel etiology of fulminant myocarditis. Herz, 45(3), 230–232. https://doi.org/10.1007/s00059-020-04909-z.
Nannoni, S., de Groot, R., Bell, S., & Markus, H. S. (2020). Stroke in COVID-19: A systematic review and meta-analysis. International Journal of Stroke, 16(2), 137–149. https://doi.org/10.1177/1747493020972922.
Kozlov, I. A., & Tyurin, I. N. (2020). Cardiovascular complications of COVID-19. Bulletin of anesthesiology and resuscitation, 17(4), 14–22. https://doi.org/10.21292/2078-5658-2020-17-4-14-22.
Sabgayda, T. P. (2017). The preventable causes of death in Russia and in the EU countries. Health Care of the Russian Federation, 61(3), 116–122. https://doi.org/10.18821/0044-197X-2017-61-3-116-122.
Sabgayda, T. P., & Semenova, V. G. (2017). Relationship between decline in cardiovascular mortality in 2013-2015 and change in mortality from other causes. Social Aspects of Population Health, (5), Article 2. https://elibrary.ru/zsvyfl.
Boytsov, S. A., & Samorodskaya, I. V. (2015). High cardiovascular mortality in Russia: Are approaches to coding causes of death adequate? Kardiologiia, 55(1), 47–51. https://doi.org/10.18565/cardio.2015.1.47-51.
Ivina, V. Yu., Karmatskikh, O. G., & Anufrieva, E. V. (2022). Assessment of the effectiveness of management of the activities of a medical organization to reduce mortality from diseases of the circulatory system based on the analysis of data on the activities of medical organizations of the Sverdlovsk region for the period 2018-2020. Journal of Ural Medical Academic Science, 19(5), 523–532. https://doi.org/10.22138/2500-0918-2022-19-5-523-532.
© Article. Tamara P. Sabgayda, Aleksandr V. Zubko, Viktoriya G. Semyonova, 2023.