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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rfhealth</journal-id><journal-title-group><journal-title xml:lang="ru">Здравоохранение Российской Федерации</journal-title><trans-title-group xml:lang="en"><trans-title>Health care of the Russian Federation</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0044-197X</issn><issn pub-type="epub">2412-0723</issn><publisher><publisher-name>Federal Scientific Center of Hygiene named after F.F. Erisman</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.47470/0044-197X-2026-70-1-37-42</article-id><article-id custom-type="edn" pub-id-type="custom">trizgr</article-id><article-id custom-type="elpub" pub-id-type="custom">rfhealth-2136</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>HEALTH CARE ORGANIZATION</subject></subj-group></article-categories><title-group><article-title>Влияние социально-экономических и демографических факторов на потребность взрослых пациентов в консультативно-диагностических услугах, предоставляемых в амбулаторных условиях</article-title><trans-title-group xml:lang="en"><trans-title>The influence of socio-economic and demographic factors on the need in adult patients for consultative and diagnostic services provided in an outpatient setting</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5113-2108</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Волнухин</surname><given-names>Артем Витальевич</given-names></name><name name-style="western" xml:lang="en"><surname>Volnuhin</surname><given-names>Artem V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Доктор мед. наук, профессор каф. общей врачебной практики Института профессионального образования, профессор каф. общественного здоровья и здравоохранения им. Н.А. Семашко Института общественного здоровья им. Ф.Ф. Эрисмана, ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет), 119991, Москва, Россия</p><p>e-mail: volnukhin_a_v@staff.sechenov.ru</p></bio><bio xml:lang="en"><p>DSc (Medicine), Professor Department of general practice, Institute of Vocational Education, Professor Department of Public Health and Healthcare named after N.A. Semashko, F.F. Erisman Institute of Public Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119991, Russian Federation</p><p>e-mail: volnukhin_a_v@staff.sechenov.ru</p></bio><email xlink:type="simple">volnukhin_a_v@staff.sechenov.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3748-8180</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Морозова</surname><given-names>Татьяна Евгеньевна</given-names></name><name name-style="western" xml:lang="en"><surname>Morozova</surname><given-names>Tatiana E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Доктор мед. наук, профессор, зав. каф. общей врачебной практики Института профессионального образования ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет), 119991, Москва, Россия</p><p>e-mail: morozova_t_e@staff.sechenov.ru</p></bio><bio xml:lang="en"><p>DSc (Medicine), Professor, Head, Department of general practice, Institute of Vocational Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119991, Russian Federation</p><p>e-mail: morozova_t_e@staff.sechenov.ru</p></bio><email xlink:type="simple">morozova_t_e@staff.sechenov.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1297-6743</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сквирская</surname><given-names>Галина Петровна</given-names></name><name name-style="western" xml:lang="en"><surname>Skvirskaya</surname><given-names>Galina P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Доктор мед. наук, профессор Института отраслевого менеджмента ФГБОУ ВО «Российская академия народного хозяйства и государственной службы при Президенте Российской Федерации», 119571, Москва, Россия</p><p>e-mail: gskvirskaya@mail.ru</p></bio><bio xml:lang="en"><p>DSc (Medicine), Professor, Institute of industry management, The Russian Presidential Academy of National Economy and Public Administration, Moscow, 119571, Russian Federation</p><p>e-mail: gskvirskaya@mail.ru</p></bio><email xlink:type="simple">gskvirskaya@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2337-7420</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Резе</surname><given-names>Андрей Геннадиевич</given-names></name><name name-style="western" xml:lang="en"><surname>Reze</surname><given-names>Andrey G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Канд. мед. наук, доцент каф. общей врачебной практики Института профессионального образования ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет), 119991, Москва, Россия</p><p>e-mail: reze_a_g@staff.sechenov.ru</p></bio><bio xml:lang="en"><p>PhD (Medicine), Associate Professor, Department of general practice, Institute of Vocational Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119991, Russian Federation</p><p>e-mail: reze_a_g@staff.sechenov.ru</p></bio><email xlink:type="simple">reze_a_g@staff.sechenov.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0004-5590-5533</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гурджар</surname><given-names>Майя Владимировна</given-names></name><name name-style="western" xml:lang="en"><surname>Gurjar</surname><given-names>Maya V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ординатор каф. общей врачебной практики Института профессионального образования ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет), 119991, Москва, Россия</p><p>e-mail: maya.v@list.ru</p></bio><bio xml:lang="en"><p>Resident, Department of general practice, Institute of Vocational Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119991, Russian Federation</p><p>e-mail: maya.v@list.ru</p></bio><email xlink:type="simple">maya.v@list.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3324-5472</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Герцог</surname><given-names>Анна Алексеевна</given-names></name><name name-style="western" xml:lang="en"><surname>Gertsog</surname><given-names>Anna A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Канд. мед. наук, ассистент каф. общей врачебной практики Института профессионального образования ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет), 119991, Москва, Россия</p><p>e-mail: gertsog_a_a@staff.sechenov.ru</p></bio><bio xml:lang="en"><p>PhD (Medicine), аssistant, Department of general practice, Institute of Vocational Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119991, Russian Federation</p><p>e-mail: gertsog_a_a@staff.sechenov.ru</p></bio><email xlink:type="simple">gertsog_a_a@staff.sechenov.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6550-2915</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Самохина</surname><given-names>Елена Олеговна</given-names></name><name name-style="western" xml:lang="en"><surname>Samokhina</surname><given-names>Elena O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Канд. мед. наук, доцент каф. общей врачебной практики Института профессионального образования ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет), 119991, Москва, Россия</p><p>e-mail: samokhina_e_o_1@staff.sechenov.ru</p></bio><bio xml:lang="en"><p>PhD (Medicine), Associate Professor, Department of general practice, Institute of Vocational Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119991, Russian Federation</p><p>e-mail: samokhina_e_o_1@staff.sechenov.ru</p></bio><email xlink:type="simple">samokhina_e_o_1@staff.sechenov.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5148-1551</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Заугольникова</surname><given-names>Татьяна Васильевна</given-names></name><name name-style="western" xml:lang="en"><surname>Zaugolnikova</surname><given-names>Tatyana V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Канд. мед. наук, доцент каф. общей врачебной практики Института профессионального образования ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет), 119991, Москва, Россия</p><p>e-mail: zaugolnikova_t_v@staff.sechenov.ru</p></bio><bio xml:lang="en"><p>PhD (Medicine), Associate Professor, Department of general practice, Institute of Vocational Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119991, Russian Federation</p><p>e-mail: zaugolnikova_t_v@staff.sechenov.ru</p></bio><email xlink:type="simple">zaugolnikova_t_v@staff.sechenov.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)<country>Россия</country></aff><aff xml:lang="en">I.M. Sechenov First Moscow State Medical University (Sechenov University)<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">ФГБОУ ВО «Российская академия народного хозяйства и государственной службы при Президенте Российской Федерации»<country>Россия</country></aff><aff xml:lang="en">Russian Presidential Academy of National Economy and Public Administration<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>04</day><month>03</month><year>2026</year></pub-date><volume>70</volume><issue>1</issue><fpage>37</fpage><lpage>42</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Волнухин А.В., Морозова Т.Е., Сквирская Г.П., Резе А.Г., Гурджар М.В., Герцог А.А., Самохина Е.О., Заугольникова Т.В., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Волнухин А.В., Морозова Т.Е., Сквирская Г.П., Резе А.Г., Гурджар М.В., Герцог А.А., Самохина Е.О., Заугольникова Т.В.</copyright-holder><copyright-holder xml:lang="en">Volnuhin A.V., Morozova T.E., Skvirskaya G.P., Reze A.G., Gurjar M.V., Gertsog A.A., Samokhina E.O., Zaugolnikova T.V.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.rfhealth.ru/jour/article/view/2136">https://www.rfhealth.ru/jour/article/view/2136</self-uri><abstract><sec><title>Введение</title><p>Введение. Для реализации пациентоориентированного подхода при оказании первичной медико-санитарной помощи необходимо учитывать в том числе социальные характеристики пациентов.</p></sec><sec><title>Цель исследования</title><p>Цель исследования: изучение влияния пола, возраста и социально-экономического статуса на потребность взрослых пациентов в консультативно-диагностических услугах, оказываемых в амбулаторных условиях.</p></sec><sec><title>Материал и методы</title><p>Материал и методы. Исследование проводилось в медицинских организациях, оказывающих медицинскую помощь в амбулаторных условиях и функционирующих в системе Департамента здравоохранения города или в частном секторе здравоохранения города Москвы. В исследовании были использованы метод выкопировки данных, статистический и аналитический методы исследования.</p></sec><sec><title>Результаты</title><p>Результаты. Потребности пациентов мужского и женского пола в консультативно-диагностических услугах являются сопоставимыми, за исключением услуг, имеющих гендерную специфичность. Однако отсутствие значимых различий нельзя считать истинным, и данный вопрос нуждается в дальнейшем изучении. Ключевыми факторами, определяющими потребность в консультативно-диагностических услугах, являются возраст и способ оплаты медицинской помощи. Возраст детерминирует объём медицинской помощи с точки зрения роста заболеваемости хроническими болезнями и мультиморбидности; способ оплаты медицинской помощи — с точки зрения рассмотрения платных медицинских услуг, как альтернативы оказываемым за счёт средств обязательного медицинского страхования в государственном секторе здравоохранения. Принадлежность к определённой социальной группе, скорее, является косвенным фактором, отражающим возрастные особенности пациента.</p></sec><sec><title>Ограничения исследования</title><p>Ограничения исследования. Основными ограничениями исследования являются локальный характер его проведения (город Москва) и отсутствие глубокого анализа связи потребности в консультативно-диагностических услугах с полом. </p></sec><sec><title>Заключение</title><p>Заключение. Преобладающий возраст обсуживаемого населения и предпочтительный способ оплаты медицинской помощи влияют на необходимое материально-техническое оснащение, штатную структуру и график работы медицинской организации, имеющие значение для реализации пациентоориентированного подхода в части ожиданий пациента.</p><p>Соблюдение этических стандартов. Исследование одобрено локальным этическим комитетом ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет), протокол № 12-22 от 02.06.2022.</p></sec><sec><title>Участие авторов</title><p>Участие авторов: Волнухин А.В. — концепция и дизайн исследования, написание текста, составление списка литературы; Морозова Т.Е., Сквирская Г.П. — написание текста, редактирование; Резе А.Г., Самохина Е.О., Заугольникова Т.В. — сбор и обработка материала; Гурджар М.В., Герцог А.А. — статистическая обработка данных. Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.</p></sec><sec><title>Финансирование</title><p>Финансирование. Исследование не имело спонсорской поддержки.</p></sec><sec><title>Конфликт интересов</title><p>Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов в связи с публикацией данной статьи.</p></sec><sec><title>Поступила</title><p>Поступила: 20.05.2024 / Принята к печати: 17.12.2025 / Опубликована: 04.03.2026</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. To implement a patient-centered approach in the provision of primary health care, it is necessary to take into account, among other things, the social characteristics of patients. </p></sec><sec><title>Purpose of the study</title><p>Purpose of the study: to study the influence of gender, age, and socio-economic status on the need in adult patients for consultative and diagnostic services provided in an outpatient setting.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. The study was conducted in medical institutions providing medical care on an outpatient basis and operating in the system of the municipal Department of Health or in the private healthcare sector of the city of Moscow. The study used the data copying method, statistical, and analytical research methods.</p></sec><sec><title>Results</title><p>Results. In male and female patients the need for consultative and diagnostic services are comparable, with the exception of gender-specific services. However, the absence of significant differences cannot be considered true, and this issue needs further study. The key factors determining the need for consultative and diagnostic services are age and method of payment for medical care. Age determines the volume of medical care in terms of the increase in the incidence of chronic diseases and multimorbidity; method of payment for medical care — from the point of view of considering paid medical services as an alternative to free ones provided in the public health sector. Belonging to a particular social group is rather an indirect factor reflecting the age characteristics of the patient.</p></sec><sec><title>Research limitations</title><p>Research limitations. The main limitations of the study are the local nature of its conduct (Moscow) and the lack of an in-depth analysis of the connection between the need for advisory and diagnostic services and gender.</p></sec><sec><title>Conclusion</title><p>Conclusion. The predominant age of the population served and the preferred method of payment for medical care influence the necessary material and technical equipment, staffing structure and work schedule of the medical institutions, which are important for the implementation of a patient-oriented approach in terms of patient expectations.</p><p>Compliance with ethical standards. Compliance with ethical standards: the study was approved by the local ethics committee of the Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University (Sechenov University), protocol No. 12-22 dated 06/02/2022.</p><p>Contribution of the authors: Volnukhin A.V. — research concept and design, writing the text, compilation of the list of literature; Morozova T.E., Skvirskaya G.P. — writing the text, editing; Reze A.G., Samokhina E.O., Zaugolnikova T.V. — collection and processing of material; Gurjar M.V., Gertsog A.A. — statistical data processing. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.</p></sec><sec><title>Funding</title><p>Funding. The study had no sponsorship.</p></sec><sec><title>Conflict of interest</title><p>Conflict of interest. The authors declare no conflict of interest.</p></sec><sec><title>Received</title><p>Received: May 20, 2024 / Accepted: December 17, 2025 / Published: March 4, 2026</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>пациентоориентированность</kwd><kwd>государственный сектор здравоохранения</kwd><kwd>частный сектор здравоохранения</kwd><kwd>оказание медицинской помощи в амбулаторных условиях</kwd><kwd>первичная медико-санитарная помощь</kwd><kwd>социальные характеристики пациентов</kwd><kwd>консультативно-диагностические услуги</kwd></kwd-group><kwd-group xml:lang="en"><kwd>patient focus</kwd><kwd>public health sector</kwd><kwd>private health sector</kwd><kwd>provision of medical care on an outpatient basis</kwd><kwd>primary health care</kwd><kwd>social characteristics of patients</kwd><kwd>consultative and diagnostic services</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Зубарева Н.Н. 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