Problems of Social Hygiene,
Public Health and History of Medicine

The publication activity is one of main criteria of assessment of scientific activity of individuals and organizations. The results publications in serious scientific journal is considered as confirmation that study is properly planned, implemented and statistically processed. The inconsistency of research planning and presentation of results in Russia to international requirements is major cause of preventing publication in prominent international editions. to overcome this problem is possible through graduate implementation of international standards initially through education of national researchers and then through development of national standard documentation related to scientific research.

The article presents technique of calculation of the planned volume of outpatient care consumed by population of the subject of the Russian Federation considering demographic structure and level of morbidity. The formulas are presented developed for calculating financial costs of outpatient care and treatment in day hospital to be included into of mandatory health insurance program.

One demographic indicator is the structure of mortality by cause. Analysis of the causes of death allows you to define the fight against the disease, efforts should be focused to reduce mortality and on the effectiveness of measures against those or other diseases. The basis of information about the causes of death is a medical certificate of death, filling it depends on the correct diagnosis, the choice of the original cause of death, coding, as well as on policy documents aimed at reducing mortality from a particular cause. In the Russian Federation, in contrast to the countries of the European region, there is a fairly high proportion of inaccurately marked conditions, which account for 6.9% of all causes (in 2010 - 5%), the main reason for this is «old age», which ranks 4th among the leading causes of death (5% of all causes, in 2010 - 2.8%), as well as damage with uncertain intentions, which are on the 7th rank place of the leading causes of death (2.3% of all causes, in 2010 - 2%).

The article discusses issue of possibility of influence of religious organizations on the attitude of population to issues of human organ transplantation. The attitude of followers of different religions to key issues of bioethics related to organ donation and transplantation is analyzed. It is concluded that there are no definite prohibitions on implementing this kind of medical intervention in modern religious regulations. The study of results of questionnaire survey of two groups of respondents revealed certain part of population, whose decision on the issues of posthumous organ donation would be influenced by the opinion of representative of religious organization. It is established that every tenth respondent appealed to the Orthodox priest when making decision to sign consent paper concerning posthumous exempt of organ from relatives. It is concluded that it is possible to affect the formation in certain part of population understanding of need to support organ donation and transplantation in case of active work in this direction of representatives of religious organizations.

The article considers one of the most pressing problems - the turnover of medicines within the common pharmaceutical market of the Eurasian Economic Union. The drug market is an essential aspect of social policy, reflecting general welfare of citizens and the level of the country's national security. The object of the study is the importation of medicines into the customs territory of the Eurasian Economic Union (EAEU), and the subject is the social and legal relationship when importing medicines, problems and ways to improve the procedure of importing medicines into the territory of the EAEU. At the present stage of development of civil society, a number of countries of the Commonwealth of Independent States are closely cooperating in improving the quality and level of living of population, complying with basic social guarantees, including providing affordable and high-quality medical and drug assistance. The indicator of country's development in the field of medicine is the ability to develop and to test drugs, because these processes are considered as the most complex, expensive and risky, as well as to control the circulation of drugs created by “pseudo-companies” producing counterfeits for well-known pharmaceutical companies. The problem of falsification leads to an outflow of capital outside the EEU, threat to health and lives of consumers, violation of the right holders’ rights, discredit foundations of the state structure of the EEU member countries that are not able to provide guarantees for the safety of drug consumption. The creation of common pharmaceutical market within the Eurasian Economic Union will in the future not only provide control of circulation of medicines on the territory of the EAEU, but also contribute to the development of national pharmaceutical industry by expanding distribution channels and expanding range of drugs produced by foreign manufacturers established on the territory of the EAEU.

The article analyzes the features of the implementation of matrimonial behavior (on the example of Kursk region). Some results of the study of the impact of adverse social and medical factors on the institution of family and marriage are presented. The aim of the study was to study the specifics of the matrimonial behavior of the population in conditions of social and medical problems. The methodology of the study was based on the theoretical analysis of the concepts of divorce. A sociological survey was conducted by questionnaire survey of the inhabitants of the Kursk region. The study, based on the analysis of the causes of family breakdown, determined that the institution of family and marriage under the influence of social and medical risks of divorce is becoming even more unstable.

In order to optimize economic and organizational technologies for the provision of medical care to the population and to increase the effectiveness of preventive programs, an analysis of the accumulated morbidity and prevalence of monogenic hereditary diseases (MHDs) has been carried out in 13 federal subjects of the Russian Federation representing 11 ethnic groups: Russians of 6 regions, Tatars, Maris, Chuvashs, Bashkirs, Udmurts, Abazins, Adygeans, Nogays, Circassians and Karachays. The study of the population was carried out according to the developed protocol of complex genetic and epidemiological studies in the Research Center for Medical Genetics, which remains unchanged throughout the study. Here we have studied the structure of the genetic load and diversity of MHDs depending on the prevalence of diseases and in accordance with the classification by organ and system types of disease: neurological, ophthalmological, genodermatosis, skeletal, hereditary syndromes, and other hereditary pathology (metabolic hereditary diseases, disorders of blood, hearing, etc.). It is shown that the maximum number of patients (61.81%) falls in the group of frequent forms of MHDs, which differ by federal subjects / ethnic groups of the Russian Federation. There are frequent forms of MHDs for all populations, and “specific” forms for particular federal subjects of the Russian Federation/ethnic groups. Only for a small group of hereditary diseases there is treatment. Most of the detected diseases-psychiatric, neurological, hematological, and hereditary syndromes-significantly reduce life expectancy. Hereditary diseases of the skeleton, eyes, ears and metabolism affect the quality of life, adaptation in society and public health. On average, 65% of patients are diagnosed with MHDs for the first time. This situation implies changes in medical thinking, changes in education and development of both common for all regions and specific prevention programs. Thus, fundamental research in medicine can improve the quality of medical services and contribute to the improvement of public health.

The article describes the principles of choosing parameters to be included into account registry of mandatory medical insurance system in 2019. The parameters should be applied for retrospective analysis of anti-neoplasm treatment of solid tumors in adults for accordance with clinical recommendations. It is proposed to extend account registries of mandatory medical insurance system with additional 13 parameters, reflecting both tumor type and course of disease and stages of medical care as well.

The analysis of a state and development of health sector in Russia is presented in article. The developed trends in receipt and expenditure of means of financing of medical services of health care in the country are revealed. The authors have identified existing problems in the field of health related to its lack of funding. Comparative characteristic of the amounts of financing of medicine is manufactured in Russia and a number of the leading foreign countries. The typology, advantages and shortcomings of various ways of financing of health sector are revealed. Characteristic and an assessment of national peculiarities of financing of health care in world practice is given. The author's approach on modernization of the model of financing of health sector existing in the country with attraction for this purpose means of the state, business and the population allowing to pass to real, ordered, economically rational consumption of medical services and to increase the responsibility of citizens for strengthening of own health is offered. This approach is focused on a gradual transition from a budget-insurance type of financing of medical services with a private-insurance type and is based on expanding the ability of citizens to manage their financial resources on accumulative medical bills. In addition, the author's approach assumes that the functions of the state will include the implementation of programs to provide socially unprotected segments of the population with medical services on favorable terms. This approach forms model of financing of health sector with considerable participation of the population in joint financing of expenses on medical services, conditions for development of systems of voluntary health insurance and implementation of programs of medical insurance taking into account a possibility of the free choice by the citizen of volume of the consumed medical services.

The publication presents the definition of key terms in pricing, sets out pricing methods, lists the current legal documents on cost indicators in health care. Methodical approaches to the calculation of remuneration, as one of the components of the cost of medical care, involve the use of labor standards of medical workers, differentiated by their participation in the therapeutic and diagnostic process. The analysis of the regulatory framework for labor in health made the need for its revision.

The article considers the third day of the Constituent Session of the USSR Academy of Medical Sciences (the USSR AMS) held on December 22, 1944. In the beginning, the Presidium of the Academy was elected. After the elections, the full members of the AMS - representatives of various medical specialties spoke. Each of them presented one's vision of development of medicine. Among speakers were A. V. Palladin, V. P. Osipov, M. S. Malinovsky, F. G. Krotkov, V. F. Zelenin, N. I. Grashchenkov, V. P. Filatov, Ya. O. Parnas, V. V. Parin, P. G. Sergiev and N. N. Burdenko. The most informative reports on the tasks of development of the AMS in the forthcoming future were made by V. V. Parin and N. N. Burdenko. The main content of this development was supposed to support synthesis of applied and fundamental knowledge in the AMS and the connection of scientific achievements and without practice. The process of establishment of the USSR AMS lasted exactly 2 years and was finalized this very day. The seventy-year history of the USSR Academy of Medical Sciences the RAMS has begun.

This article provides an overview of the change of topics in the medical-geographical studies in Russia. It highlights the conventional nature of this science, its dependence on political, ideological and scientific demands as well as institutional difficulties. It concludes that the goal of further historical research is to focus on the restoration of synchronous meanings of medical geography, its links with other disciplines and the elucidation of Russia's participation in the transnational project of medico-geographical research.

In recent years scientists actively study the influence of domestic violence on psychological status and occurrence of mental disorders in women and girls. Psychological, physical, sexual and other types of violence are distinguished, the consequences of which are studied in many countries under the auspices of WHO. In international studies the serious consequences of domestic violence for women are investigated. It was found out that women develop stressful disorders, depression and dependence on psychoactive substances. Negative influence of domestic violence at girls is expressed in formation of behavioral disorders, violations of sexual development, suicidal trends. At analysis of consequences of domestic violence by WHO was developed the concept of “cycle of violence” and cruelty inside family when in process of long influence of psychological traumatic factors at women and girls aggressive actions occurred so that victim and aggressor changed places.The objective of the study was to analyze the current state of the problem on the basis of the literature data, to study the data on the consequences of domestic violence and cruelty against women and girls, to identify gender-specific violations.