Проблемы социальной гигиены, здравоохранения и истории медициныПроблемы социальной гигиены, здравоохранения и истории медицины0869-866X2412-2106Joint-Stock Company Chicot33610.32687/0869-866X-2020-28-4-596-599Научная статьяClinical and organizational assessment of endovascular care accessibility at the regional levelAbramovA. U.-Goloshchapov-AksenovR. S.-SemenovV. Yu.-KichaD. I.d_kicha@mail.ruRukodaynyyO. V.-1512202028459659906042021Copyright © 2020, АО "Шико"2020The world health care system´s concern of inequalities in treatment of receiving the necessary medical care. The purpose of article to evaluate the availability of endovascular care (EVC) for patients at regional level in Russia and to develop a system for its improvement. As a result the low availability of EVC for the population at the regional level in Russia with coronary heart disease, atherosclerosis of the brachiocephalic arteries and critical lower limb ischemia (CLLI) was funded. The main reasons for the difficulties in obtaining EVC in the regions of Russia are the low frequency of diagnosing a critical stage of cardiovascular disease (CVD) requiring surgical treatment, the absence of cardiovascular surgeons and cardiologists in the medical care organizations, the failure in information to patients attending a regular doctor´s appointment about effectiveness and safety of endovascular treatment technology. More old-school traditional methods remain in place like bypass or endarterectomy surgery. Further obstacles are prolonged waiting list at the regional level for the provision of high-tech care in cardiovascular surgery, choice of conservative treatment methods or amputation of lower limbs for patients with CLLI 3 and 4 st. (p <0.05).In Conclusion the Clinical and organizational assessment of the endovascular care accessibility in CVD for the population in regions of Russia elaborated. One way to improve the situation is the introduction of the cardiovascular care clinical management. A dual-circuit clinical and organizational system was developed and proposed to increase endovascular care accessibility in regions.endovascular carehealth care accessibilitycardiovascular diseaseatherosclerosisclinical, organizational, regional level1.Kontsevaya A. V., Drapkina O. M., Balanova Yu. A., Imaeva A. E., Suvorova E. I., Khudyakov M. B. Economic damage to cardiovascular diseases in the Russian Federation in 2016. Rational pharmacotherapy in cardiology. 2018;14(2):156-66.2.Bolotova E. V., Kontsevaya A. V., Kovrigina I. V., Lyuberitskaya L. P. Gender-age characteristics of mortality from diseases of the circulatory system on the example of the attached population of the territorial clinic of Krasnodar. Kuban Scientific Medical Bulletin. 2019;26(3):99-107.3.Puska P., Tuomilehto J., Nissenen A., et al. The North Karelia Project. 20 Year Results and Experiences. 1995. 121 p.4.Stachenko S. CINDI-Canada. Preventative medicine. 2017;(2):16-8.5.Bykovskaya T. Yu. The role of the National project «Health» in improving the health indicators of the working population. Occupational medicine and industrial ecology. 2001;(3):19-23.6.Widimsky P., Fajadet J., Danchin N. «Stent for life» targeting PCI at all who will benefit the most. A joint project between EAPCI, EuroPCI, EUCOMED and the ESC Working Group on Acute Cardiac Care. Eurointervention. 2009;4:555-7.7.Hiramoto J., Teraa M., Borst G., Conte M. Interventions for lower extremity peripheral artery disease. Nat Rev Cardiol. 2018;15(6):332-50.8.Bokeria L. A., Alekyan B. G. Endovascular diagnosis and treatment of heart and vascular diseases in the Russian Federation. 2016 year. Moscow: NTSSSH im. A. N. Bakuleva RAMS; 2017. 179 p. (in Russian).9.Pokrovsky A. V., Golovnyuk A. L. The state of vascular surgery in the Russian Federation in 2018. Angiology and vascular surgery. Application. 2019;25(2):48.10.Danilov A. V., Moskovchenko K. B. Inter-territorial settlements in the field of compulsory health insurance and their impact on regional health care. Bulletin of Voronezh State University. Series: Economics and Management. 2018;(2):25-32.11.Merkov A. M., Polyakov L. E., Sanitary statistics. Moscow: Meditsina; 1974. 384 p.