

Assessment of medical care provided to patients with obstructive lung diseases in the federal districts of the Russian Federation
https://doi.org/10.47470/0044-197X-2025-69-4-342-349
EDN: iafnny
Abstract
Introduction. Obstructive lung diseases have a significant impact on the country’s economy. The factors that influence on the level of medical care for these patients remain poorly understood. The influence of some factors of public health determinants on the mortality rate in patients from broncho-obstructive diseases has been studied.
Materials and methods. We calculated the correlation coefficient between specific factors of public health determinants, after which each pair of correlation coefficients was assigned a coefficient: for a correlation coefficient value of 0.9 or higher — 1; 0.70–0.89 — coefficient 0.9; 0.50–0.69 — coefficient 0.8; 0.30–0.49 — coefficient 0.7; less than 0.29 — 0.6. Then we calculated the total score obtained by multiplying standardized indicators of each studied factor by the coefficient, which calculation described above, for each federal district.
Results. A very strong inverse correlation was found between mortality and economic factors, the number of annual treatment courses, the smoking prevalence, as well as the amount of funds spent on drug provision. A strong inverse correlation was observed with the level of funds spent on preferential drug provision. The correlation with the frequency of use of fixed triple combinations of drugs and the sum of compulsory medical insurance funds spent on drug provision was moderate. The link with availability for pulmonologists was weak, while there was no connection with availability of general practitioners. Calculation of the total scores of the studied factors revealed a substantially higher value in St. Petersburg — 29.3. Moscow and the Northwestern Federal District (excluding St. Petersburg) had totals two or more times lower than just St. Petersburg alone. The lowest total score was in the North Caucasian Federal District.
Research limitations. The study is limited by the examined public health determinants.
Conclusion. An integrated assessment of the quality of medical care provided to patients with obstructive lung diseases based on an analysis of public health determinants can serve a tool for the healthcare management in the federal districts of the Russian Federation.
Compliance with ethical standards: the study does not require the submission of the opinion of the biomedical ethics committee or other documents.
Contribution of the authors:
Linnik S.A. — research concept and design, writing the text, compilation of the list of literature, statistical data processing;
Avdeev S.N. — research concept and design, editing;
Tumenko E.N. — research concept and design, collection and processing of material;
Shvachko S.A. — collection and processing of material.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.
Funding. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
Received: January 16, 2025 / Accepted: June 24, 2025 / Published: September 12, 2025
About the Authors
Sergey A. LinnikRussian Federation
DSc (Medicine), leading researcher, N.A. Semashko National Research Institute of Public Health, Moscow, 105064, Russian Federation; general manager, Scientific Medical Society “Medical Practice”, Moscow, 105064, Russian Federation
e-mail: Linnik2001@mail.ru
Sergey N. Avdeev
Russian Federation
DSc (Medicine), Professor, Academician of RAS, Head, Pulmonology department, I.M. Sechenov First Moscow State Medical University (Sechenov University), chief freelance pulmonologist, Ministry of Health of Russian Federation, Moscow, 119048, Russian Federation
e-mail: serg_avdeev@list.ru
Elena E. Tumenko
Russian Federation
Director for the strategic development, Scientific Medical Society “Medical Practice”, Moscow, 117342, Russian Federation
e-mail: Tumenko@list.ru
Sergey A. Shvachko
Russian Federation
Director for marketing, Scientific Medical Society “Medical Practice”, Moscow, 117342, Russian Federation
e-mail: sashvachko@yandex.ru
References
1. Avdeev S.N., Nenasheva N.M., Zhudenkov K.V., Petrakovskaya V.A., Izyumova G.V. Prevalence, morbidity, phenotypes and other characteristics of severe bronchial asthma in Russian Federation. Pul’monologiya. 2018; 28(3): 341–58. https://doi.org/10.18093/0869-0189-2018-28-3-341-358 https://elibrary.ru/xwcrrz (in Russian)
2. Global Initiative for Asthma. 2018 GINA Report, Global Strategy for Asthma Management and Prevention. Available at: https://ginasthma.org/wp-content/uploads/2023/04/GINA-Main-Report-V1.3-2018-WMSA.pdf
3. Mannino D.M., Buist S. Global burden of COPD: risk factors, prevalence, and future trends. Lancet. 2007; 370(9589): 765–73. https://doi.org/10.1016/s0140-6736(07)61380-4
4. Drapkina O.M., Kontsevaya A.V., Mukaneeva D.K., Smirnova M.I., Antsiferova A.A., Lukyanov M.М., et al. Forecast of the socioeconomic burden of COPD in the Russian Federation in 2022. Pul’monologiya. 2022; 32(4): 507–16. https://doi.org/10.18093/0869-0189-2022-32-4-507-516 https://elibrary.ru/mzwuqy (in Russian)
5. Linnik S.A., Avdeev S.N., Tumenko E.E. The influence of the dynamics of the cost of drugs for the treatment of patients with broncho-obstructive diseases on the availability of drug treatment in the Russian Federation. Menedzher zdravookhraneniya. 2025; (1): 66–75. https://doi.org/10.21045/1811-0185-2025-1-66-75 https://elibrary.ru/ascbvx (in Russian)
6. Tishutin A.A. The financial mechanisms in health care system and medical services. Problemy sotsial’noi gigieny, zdravookhraneniya i istorii meditsiny. 2021; 29(5): 1179–85. https://doi.org/10.32687/0869-866X-2021-29-5-1179-1185 https://elibrary.ru/dizeqo (in Russian)
7. Andreeva O.V. Modern approaches to the development of financial policy and financial mechanism in health care. Nauchno-metodicheskii elektronnyi zhurnal «Kontsept». 2014; (T20): 3771–5. https://elibrary.ru/sjfalb (in Russian)
8. Yakovleva I.V. Increasing the efficiency of healthcare financing. Innovatsionnoe razvitie ekonomiki. 2019; (5-1): 207–13. https://elibrary.ru/vybety (in Russian)
9. Total pharmaceutical expenditure as % of total health expenditure. Available at: https://gateway.euro.who.int/en/indicators/hfa_578-6770-total-pharmaceutical-expenditure-as-of-total-health-expenditure/#id=19673
10. Ulumbekova G.E., Ginoyan A.B., Kalashnikova A.V., Alvianskaya N.V. Healthcare financing in Russia (2021–2024). Facts and suggestions. ORGZDRAV: novosti, mneniya, obuchenie. Vestnik VSHOUZ. 2019; 5(4): 4–19. https://doi.org/10.24411/2411-8621-2019-14001 https://elibrary.ru/wxqqbn (in Russian)
11. Rimashevskaya N.M., Migranova L.A., Molchanova E.V. Factors impacting on the state of health of the Russian population. Narodonaselenie. 2011; 51(1): 038–49. https://elibrary.ru/pkxgpf (in Russian)
12. Yerugina M.V., Krom I.L., Shmerkevich A.B., Dorogoykin D.L., Zhuzhlova N.Yu., Shigaev N.N., et al. The аvailability of medical care as an obligatory social health predictor of the population in Russia (review). Saratovskii nauchno-meditsinskii zhurnal. 2016; 12(2): 101–5. https://elibrary.ru/wzxgrl (in Russian)
13. Linnik S.A. Information technologies for management of medicine provisions for patients with malignant neoploges: Diss. Мoscow; 2023. (in Russian)
14. Kossova T.V. Economic determinants of mortality from cardiovascular diseases in Russian Regions. Voprosy statistiki. 2023; 30(1): 42–51. https://doi.org/10.34023/2313-6383-2023-30-1-42-51 https://elibrary.ru/sugazg (in Russian)
15. Samorodskaia I. V., Semenov V.Iu., Boitcov S. A. The impact of medical and non-medical factors on population mortality: phenotype and behavioral factors. Problemy sotsial’noi gigieny, zdravookhraneniya i istorii meditsiny. 2018; 26(5): 260–5. https://doi.org/10.32687/0869-866X-2018-26-5-260-265 https://elibrary.ru/mimqct (in Russian)
16. Balashova S.A., Zakharchuk А.R., Sidorenko М.V. Estimates of the interrelation of the level of socio-economic development and the mortality rate in Russian regions. Vestnik Rossiiskogo universiteta druzhby narodov. Seriya: ekonomika. 2020; 28(1): 83–97. https://doi.org/10.22363/2313-2329-2020-28-1-83-97 https://elibrary.ru/wcdvpg (in Russian)
17. Avdeev S.N., Nikitina L.Yu., Merzhoeva Z.M., Nuralieva G.S., Gainitdinova V.V., Dzhioeva O.N., et al. Reality and prospects of the pulmonological care for patients with chronic obstructive pulmonary disease in the Russian Federation. RMZH. 2024; (1): 2–6. https://elibrary.ru/hulvxy (in Russian)
18. Komleva N.E., Trubetskov A.D., Danilov A.N., Shevchuk L.M., Gadyatskiy A.Yu. Medical and social aspects of quality of life related to health. Zdorov’e naseleniya i sreda obitaniya – ZNiSO. 2016; (9): 13–4. https://elibrary.ru/wmdign (in Russian)
19. Weaver S.R., Dai D., Stauber C., Luo R., Rothenberg R. The Urban Health Index: A Handbook for its Calculation and Use. Available at: https://researchgate.net/publication/281494847_The_Urban_Health_Index_A_handbook_for_its_calculation_and_use
20. Vasilieva T.P., Larionov A.V., Russkikh S.V., Zudin A.B., Vasunina A.E., Vasiliev M.D. Calculation of the public health index in the regions of the Russian Federation. Zdorov’e naseleniya i sreda obitaniya – ZNiSO. 2022; 30(12): 7–16. https://doi.org/10.35627/2219-5238/2022-30-12-7-16 https://elibrary.ru/dujcsw (in Russian)
Review
For citations:
Linnik S.A., Avdeev S.N., Tumenko E.E., Shvachko S.A. Assessment of medical care provided to patients with obstructive lung diseases in the federal districts of the Russian Federation. Health care of the Russian Federation. 2025;69(4):342-349. (In Russ.) https://doi.org/10.47470/0044-197X-2025-69-4-342-349. EDN: iafnny