High-tech health care: achievements and current problems

Aim. To justify the need to shift priorities in the allocation of health care resources by the analysis of volumes and results of providing high-tech health care in cardiovascular surgery.

Material and methods. The sources of information were federal statistical monitoring forms, the European Health Information Portal of the World Health Organization, compulsory health insurance (CHI) registries, annual reports of the Federal CHI Fund, population mortality data from the C51 form of Rosstat, and the Federal Laws "On the Federal Budget". Descriptive statistics methods and regression analysis were used.

Results. Due to a significant increase in the number of expensive endovascular coronary interventions in recent years, the Russian Federation has achieved a leading position in the world in providing the population with this type of high-tech health care. At the same time, the target indicators of the federal project on cardiovascular diseases to reduce MI mortality have not been achieved. Every year, <70% of expensive coronary artery stenting interventions are performed on the same individuals, while more than half of deaths from MI occur outside a medical facility. In addition, the proportion of working age people dying from MI is increasing. The program of state guarantees for free health care in 2025 for the first time established standard hospitalization rate for high-tech care for myocardial infarction. It is 1,5 times higher than the actual hospitalization rates with this diagnosis, which indicates the impossibility of their real implementation.

Conclusion. The volumes and growth rates of endovascular coronary interventions in Russia do not correspond to the budgetary capabilities of the country's financial system and do not have the expected positive impact on public health. Priorities in the allocation of health care resources should be shifted — from increasing the volume of high-tech medical care to strengthening primary health care services, which implies a political choice and requires long-term commitment to this course.

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