K. V. Gerasimova

The content and/or weight coefficients of Russian diagnosis-related groups (DRG) for inpatient and day care payment have been updated for 2026. Following clinical guidelines, changes were made in DRG for payment of therapy for malignant neoplasms in adults, intestinal infections and infections caused by polyresistant microflora. Six new groups were formed to pay for preimplantation genetic testing in fertilization in vitro (IVF). Weight coefficients of DRG for the treatment of chronic viral hepatitis B and C, for using genetically engineered biological agents and selective immunosuppressants, as well as IVF were recalculated. Three new groups were formed in medical rehabilitation profile. Accounting for the dose of normal human immunoglobulin in the treatment of complex neurological diseases was introduced.

Telehealth is becoming increasingly relevant and in demand as a technologically advanced area in healthcare. The telehealth approach in the management of patients with diabetes mellitus (DM) has the potential to improve disease management. Objective. To analyze the effectiveness of telehealth methods in correcting the level of glycated hemoglobin in patients with type 1 and type 2 diabetes mellitus. Materials and methods. We searched for meta-analyses with the keywords “telehealth” AND “diabetes” AND “meta-analysis” in the MEDLINE database (PubMed) and the words “telemedicine”, “diabetes”, “meta-analysis” in the RSCI database (eLibrary) until March 1, 2025. Results. The analysis includes 19 papers evaluating the use of telehealth technologies for the treatment of patients with diabetes. The effectiveness of telehealth in reducing the level of glycated hemoglobin ranged from –0.18% to –0.64% compared to traditional control (face-to-face visits of patients). Conclusion. Telehealth technologies can be effective in reducing glycated hemoglobin levels in patients with type 1 and type 2 diabetes mellitus; however, additional studies on the clinical and cost-effectiveness of telehealth monitoring are required to justify its wider introduction into practice.

Objective. To develop an expert questionnaire for proposals regarding improvement of organization of medical care in patients with cancer. Material and methods. We used the Order of medical care to adult patiens with cancer, clinical recommendations, medical care standards, other regulatory legal acts devoted to organization of medical care, passport of federal project “Fighting Oncological Diseases”, analytical notes devoted to realization of this federal project in regions of the Russian Federation. This 4-stage study included content analysis, comparative legal analysis, classification analysis, decomposition and synthesis methods, analytical method and multi-criteria decision analysis (MCDA). Results. An expert questionnaire was developed to formulate and prioritize proposals for improving the organization of medical care for patients with cancer. The questionnaire consists of 5 parts. Part 1 (4 sections) is devoted to assessing the current indicators of oncology service and generating proposals for adding new indicators or groups of indicators. Part 2 (2 sections) is devoted to assessing the current activities and results in fighting against cancer, as well as formulation and assessment of new activities and results for the new period of the project. Part 3 (2 sections) presents approaches to assessing the changes in organizational structure of oncological services in constituent entities of the Russian Federation. Part 4 (2 sections) involves development of parameters for availability of medicines and effectiveness of antitumor non-drug therapy (radiotherapy, radionuclide and surgical treatment). The 5th part of the questionnaire (2 sections) involves developing parameters for the accessibility and effectiveness of non-drug treatment (radiation therapy, radionuclide and surgical treatment methods). Three groups of experts will analyze survey data using descriptive statistics, Kendall’s coefficient and Cronbach’s alpha: 1) healthcare managers at the level of medical organization; 2) health care managers with experience in organizational and methodological work at the level of constituent entity of the Russian Federation; 3) oncologists. Conclusion. We developed an expert questionnaire for generating proposals for improving the organization of medical care in patients with cancer. This questionnaire is based on the principles of MCDA. Further testing of this questionnaire in different groups of experts and comparison of results are necessary.

We analyzed the feasibility and introduction of assessing the quality of care into information system of the Pirogov Moscow City Clinical Hospital No. 1. The indicators for quality of care were approved by the Order of the Ministry of Health of Russia dated May 10, 2017 No. 203n «On approval of criteria for assessing the quality of medical care». Compliance with this order is mandatory for all hospitals in the Russian Federation. One of the possible options for introducing the indicators is implementation into medical information system with automatic assessment. In case of the Pirogov Moscow City Clinical Hospital No. 1, the optimal approach was semi-automatic checking with introduction of certain indicators into information system. Indeed, they contain «subjective» information not standardized for digitalization. It is difficult to evaluate these data automatically using electronic medical records. Considering the peculiarities of IT environment in this hospital, the following option was preferred. Decision-making support is carried out in unified medical information analitical system (rus. EMIAS) through self-monitoring checklists. This functionality is called the «Handbook of Standards» and allows you to display a checklist of necessary prescriptions in interface after establishing a diagnosis. Application of quality criteria after a completed treatment case is automatically controlled in the other information system “Interin”, because EMIAS does not allow to assess the self-monitoring check-lists in medical organizations. There is selective manual checking of medical documentation regarding quality assessment criteria that are not implemented for objective reasons.

Aim. The evaluation of absolute and relative difference in the growth of standard rates and financing of medical help based on the calculation for Program on State Guarantees to Deliver Free Medical Care to the Citizens of the Russian Federation (PSG) by the parameters approved by the Decree of the Government for 2019 and 2020.Materials and methods. The evaluation was performed by the methods of mathematic modeling. Mathematic modeling of the calculation of the volumes of medical help (MH) and financial costs in the subjects of the RF was based on the Decrees of the Government for 2019 and 2020 and the method of calculation of the standard rates specified in the Letter on the economic grounds for territorial PSG. Modeling for each region was used to compare the absolute and relative difference in the growth of standard rates for the obtained values in the absolute and relative expression of the calculated planned parameters of PSG for 2019 and 2020 according to the described method in terms of types, conditions, and profiles of medical help.Results. It was revealed that the existing standard rates for financial costs did not provide a uniform growth of costs by all the conditions and types of MH. The growth of financing by types and conditions varied from 1.43 to 9.59% of the 2019 baseline in the RF. Certain “specialized” (profile) standard rates within the conditions of MH showed a significant growth at a slower growth of financing of the rest of MH types (3.86% for all-day inpatient service and -0.6% (decrease in financing) for day-time inpatient service). The calculation of the model for the subjects of the RF showed even greater fluctuations: from –0.11% to –3.03% for day-time inpatient service and from 1.35% to 7.27% for all-day inpatients service.Conclusion. Despite the annual growth of the financing of PSG, redistribution of the budget within the conditions of medical service provision is uneven. This situation provides background for the improvement of the mechanisms of planning of MH within PSG using obligatory modeling and balanced standard rates for the subjects of the RF.