Problemy sotsial''noi gigieny i istoriia meditsiny / NII sotsial''noi gigieny, ekonomiki i upravleniia zdravookhraneniem im. N.A. Semashko RAMN, AO ''Assotsiatsiia ''Meditsinskaia literatura''最新文献

The relevance of this study is due to the fact that the Government of the Russian Federation has approved a strategic direction in the field of digital transformation of healthcare until 2030, contributing to the achievement of technological sovereignty and ensuring conditions for the development of the countrys healthcare sector. In this context, an overview of the current situation in the field of digital healthcare at the national and international levels was conducted. The authors analyzed the regulatory documents of the Russian Federation and scientific publications (RSCI, PubMed), selecting 22 domestic and 6 foreign works (2023-2024) on the digital transformation of healthcare. Based on PRISMA, an assessment of the quality of research was carried out, new analytical data on current trends and prospects for the development of digital healthcare were obtained. This review includes an analysis of the practical implementation of digital healthcare initiatives and a critical examination of the formation and effectiveness of the relevant regulatory framework in the country. The current main scientific and practical directions of the digital transformation of domestic healthcare were also considered. In addition, the results of the study of current priority trends in the digital development of foreign healthcare are presented. This allowed us to form a holistic view of the achievements and challenges facing the healthcare system in the era of digitalization.

The relevance of this study stems from the fact that the prevention of behavioral risk factors in primary health care (PHC) is an effective measure that can reduce not only morbidity but also the burden on healthcare systems. However, the implementation of effective practices, policies, and approaches remains uneven, necessitating an examination of the best strategies, barriers, and opportunities to optimize preventive care at the PHC level. A search in the PubMed, Scopus, and WHO IRIS databases for the period 2019-2025 identified 48 relevant open-access sources. Using PRISMA guidelines, the quality of the studies was assessed, and data on current interventions implemented within PHC systems were obtained. The findings highlight the effectiveness of integrated PHC models, such as multidisciplinary teams and network-based collaboration, in reducing modifiable risk factors. Among the key successful approaches are the use of digital technologies, risk stratification, integration with local communities, and outcome-based financing. The main barriers include fragmented healthcare systems, limited resources, and low coverage of vulnerable groups. The review confirms the need to adapt effective strategies to national and regional contexts to optimize the prevention of chronic noncommunicable diseases.

This article examines the factors influencing doctors motivation to stay in their profession. For this purpose, a sociological survey was conducted, which was attended by 428 medical workers of various specialties working in public health institutions in Moscow and the Moscow region. The survey consisted of several key sections, including personal, professional, social, and economic aspects, which revealed both internal and external motivations shaping doctors attitudes toward their profession. The results show that 57% of respondents chose the profession of a doctor out of a desire to help people, which highlights the altruistic nature of medical practice. However, higher workloads, economic instability, and lack of respect for the profession pose significant challenges. Despite this, a significant part of the doctors surveyed express satisfaction with their work, which indicates internal motivation and a desire for constant self-improvement. The article summarizes the popularity of professional communities, the level of financial expectations and the importance of family support, and identifies changes that could improve the working conditions of medical professionals.

The effectiveness of the management of medical organizations, on which the quality of medical services and the health of Russians depend, is today a cornerstone in solving and achieving strategic health-saving objectives. Russian medicine uses the most advanced technologies and digital solutions that contribute to the effective organization of the work of medical workers, allow them to realize patient-centricity and improve the quality of medical services provided. The purpose of the study is to search for approaches to creating and implementing a CRM application model as a new format for implementing patient-centricity in the Ministry of Health of the future. To achieve this goal, a range of different techniques was used: analytical, logical and systematic approaches to the analysis of secondary data. The empirical part of the study is a survey of the expert community, which allowed us to build/obtain a matrix diagram of the relationship between CRM functionality and HR management processes in the Ministry of Defense. As a result, a conceptual model of CRM implementation in the MO is proposed, which takes into account the demand from patients for the services of a particular MO, taking into account its capabilities. The results obtained within the framework of the research topic will improve the efficiency of the Ministry of Defense due to a more efficient and optimal workload of medical specialists and a more complete «understanding of needs» on the part of the population based on the implementation of CRM.

The Russian Federation continues a phased reform of the higher professional education system, which focuses on the development of professional competencies among medical professionals. But the development of professional competencies should not go only by replenishing the baggage of skills with narrow-profile knowledge and skills. The competence-based model of continuing medical education implies the formation of a legal culture and the necessary level of legal literacy for a doctor. Knowledge and compliance by medical professionals with the norms of current legislation is the basis for the functioning of the healthcare system, legal literacy is the key to professional protection of their activities. The purpose of the study is to substantiate the need to develop an educational trajectory for the development of professional competencies among medical professionals (using the example of legal competence).

Materials and methods: The sociological method (studying the opinion of respondents), the statistical method (evaluating the results of a sociological survey).

Results: When determining the need to improve legal literacy among specialists in the field of public health and healthcare organizations, a sociological survey was conducted that revealed a lack of legal knowledge, primarily the lack of a structured understanding of the basic laws setting out the basics of the rights and obligations of subjects of medical care, and basic regulatory legal acts regulating medical activities.

Conclusions: The availability of legal competencies would allow health workers to effectively master the methods of crime prevention in providing assistance, control the occurrence of conflict situations, as well as find solutions to complex ethical and legal issues. A modern doctor, and especially a healthcare organizer, must confidently navigate the legal context of his activities, legal information, and use legal knowledge in his work.

Modern society is facing numerous challenges in the field of healthcare, which require young people to make an informed choice of profession. In an ever-changing social and economic environment, the question of what motivates young people to choose a medical profession is becoming an increasingly relevant topic for research. This article provides an in-depth analysis of the many motivational factors that play a key role in deciding on a medical career. The work covers psychological, social and economic aspects that shape the motivation of future doctors. Psychological factors include inner aspirations and personal beliefs, such as a desire to help people, an interest in science, and an attraction to the humanities of medicine. Social aspects consider the influence of the environment, including family values and cultural expectations, which may encourage young people to choose this profession. Economic factors focus on financial expectations and career opportunities in medicine. Based on a sociological study conducted among students and applicants of medical universities, the article highlights the key motivators influencing the choice of a doctors profession. The results of this work can serve as a basis for the development of programs aimed at attracting and retaining young people in the medical profession, which is important for the future of healthcare.

The relevance of this study stems from the global challenge of population aging. This review, conducted according to PRISMA methodology based on the analysis of 45 scientific articles (2019-2025), systematizes key social and medical determinants of aging. Evidence indicates that socioeconomic status (SES) is a fundamental factor: low SES increases the risk of dementia, multimorbidity, and accelerated biological aging by limiting access to healthcare and healthy lifestyle choices. Conversely, education serves as a powerful protective factor, increasing vitality indicators by 15-30% through programs like «Universities of the Third Age». Social isolation shows a significant correlation with cognitive impairment and depression, as evidenced, for example, by a 23% decrease in the Active Longevity Index (ALI) observed in rural regions of the Russian Federation. Lifestyle factors, including nutrition and physical activity, are equally critical, as is the detrimental impact of environmental pollution in accelerating aging. Among medical determinants, chronic diseases (cardiovascular disease, diabetes) and frailty/sarcopenia, affecting 52% of individuals over 80, play a leading role. Access to geriatric care remains limited (lt; 10% in low-income countries); however, telemedicine and the integration of geriatricians into primary care settings demonstrate efficacy. Genetic and environmental factors also exert a significant, unconditional influence on aging processes. Thus, the principal determinants influencing the quality of life of older adults inform the direction of efforts aimed at developing a comprehensive policy framework to combat premature aging.

The article examines the forms and content of network interaction between medical universities and commercial enterprises in the context of the transformation of the scientific and educational environment. The potential of such partnerships for the development of applied medical research, innovative entrepreneurship, and healthcare staffing is analyzed. The key mechanisms of cooperation are substantiated: technological alliances, RD clusters, incubators and educational consortia. Ethical, legal and organizational barriers to cooperation are noted. It is concluded that there is a need for regulatory and institutional support for networking as a tool for shaping the «fourth mission» of universities.

The article examines the critical role of measurement uncertainty assessment in ensuring the reliability of the results of clinical diagnostic laboratories. A two-component measurement uncertainty model is analyzed which includes a component related to the traceability of results to the highest standards provided by the manufacturer of in vitro diagnostic systems and a component characterizing the reproducibility of measurements in a specific laboratory evaluated on the basis of in-laboratory quality control. The methodology for calculating the total measurement uncertainty is presented and its mandatory indication along with the analysis result in the format «Value ± measurement uncertainty (%)» which determines the range of possible values of the true value. The clinical importance of taking measurement uncertainty into account when interpreting laboratory data is emphasized. Using the example of the threshold value of anti-Muller hormone for deciding on the possibility of in vitro fertilization it is demonstrated how ignoring the uncertainty interval can lead to an erroneous refusal of treatment. The key challenges of the widespread introduction of measurement uncertainty into practice are noted: the need to maintain clinical diagnostic laboratories in a state of statistical manageability ensuring the reliability and completeness of data from in vitro diagnostic manufacturers modifying laboratory forms and most importantly training clinicians in the principles of interpreting results taking into account uncertainty. It is concluded that the integration of measurement uncertainty into routine laboratory reporting and clinical decision-making is a necessary condition for improving diagnostic quality minimizing errors and ensuring patient safety.

Elimination of personnel shortage in healthcare has been one of the key tasks for several years. The reasons for the shortage of specialists have long been studied, but the situation is not changing as fast as we would like. The solution to the problem of shortage of medical workers, first of all, is the creation of suitable working conditions and opportunities for self-realization of healthcare personnel, while it is important to start the formation of a personnel reserve by attracting schoolchildren to the profession, then maintaining interest in the profession during training, and also promoting the adaptation and professional development of young specialists when they are employed. The purpose of this study is to identify the role of mentoring at each stage of the career trajectory of a young specialist. The information basis of the study is the data of sociological studies devoted to identifying modern challenges in the development of human resources in the healthcare system and organizational aspects of mentoring, in 2023-2024 in medical organizations subordinate to the Department of Health of the City of Moscow. The present study proposes to use a model of a "seamless" career trajectory for a health worker through a mentoring system.