National health systems are experiencing a number of common global challenges: population growth, demographic ageing, the prevalence of chronic noncommunicable diseases, the constant growth of health-care costs, while increasing resource scarcity, including staffing. At the same time, the rapid development of information technologies, including the accumulation of big data, artificial intelligence, telemedicine, remote patient monitoring, and the increasing availability of high-performance mobile devices and a high-speed Internet connection create truly unique prospects for the development of digital healthcare products and services. Growth of investment from tech giants and venture capital funds is one of the main drivers of digital healthcare transformation. More and more innovative products are being offered not to enhance the effectiveness of existing processes within health systems, but to create new alternative ways to receive medical care or reduce problems in its delivery. Thus, a key customer and a user of digital healthcare products is gradually becoming not the heads of medical organizations, public health authorities or doctors, but patients themselves. In this article, we present an analysis of the existing global trends and directions of development of the digital healthcare market, form our image of the future and the most prospective scenarios and technologies for products and services in this area.

By 2050, the proportion of people over 60 years of age worldwide is expected to be 22 %, and the number of people over 80 is expected to triple by that time, reaching 426 million. Population aging threatens the sustainable functioning of national health care systems, since the increase in the proportion of the elderly population is accompanied by increased costs for the health care system and a decrease in the availability of medical care for other age groups. Based on the analysis and synthesis of data from foreign publications on the impact of population aging on the sustainability of the functioning of national healthcare systems, proposed measures and models of medical care that take into account changes in the age structure of the population are systematized. Analysis of foreign publications made it possible to identify the following challenges for the healthcare system associated with the aging population: rising costs of providing medical care, the need to increase emphasis on preventive measures, increasing prevalence and severity of chronic non-communicable diseases and comorbidity, inequality in access to medical care, expressed in territorial (regional), age and gender aspects, as well as determined by the socio-economic status of a person. Experts suggest that the most obvious and realistic solution to the problem is active prevention of chronic diseases and more intensive monitoring of the health status of the population. Digital solutions that provide disease prevention and remote monitoring of the health status of the elderly population, based on the use of machine learning technologies, artificial intelligence and telemedicine technologies, are identified as promising areas for limiting healthcare costs.

Пандемия новой коронавирусной инфекции SARS-CoV-2 (COVID-19) вызвала беспрецедентную нагрузку на системы здравоохранения во всем мире. Российская Федерация продемонстрировала высокий уровень готовности к борьбе с пандемией COVID-19. Прежде всего, это выразилось в оперативном перераспределении ресурсных мощностей в сторону эффективного оказания медицинской помощи пациентам с COVID-19. С этой целью для данного контингента специально созданы временные госпитали, а также перепрофилирован имеющийся коечный фонд. Разработаны и утверждены схемы маршрутизации пациентов с острыми респираторными вирусными инфекциями (ОРВИ) и внебольничной пневмонией. Утверждены временные правила учета информации и ведения информационного ресурса учета информации в целях предотвращения распространения COVID-19 с использованием единой государственной информационной системы в сфере здравоохранения. С декабря 2020 г. в нашей стране начата масштабная, а с января 2021 г. — массовая вакцинация взрослого населения против COVID-19. Мобилизация кадровых ресурсов страны для борьбы с пандемией, своевременное доведение до врачей актуальных клинических рекомендаций о лечении пациентов позволили эффективно ответить на вызовы пандемии COVID-19. Возвращение системы здравоохранения в обычный режим деятельности является первоочередной задачей на современном этапе.

Two polymorphisms in the IL4 (G/C 3′‐UTR) and IL5 (C‐703T) genes were studied in a sample of families whose probands had atopic bronchial asthma (BA) (66 families, n = 183) and in a group of non‐cognate individuals with the severe form of the disease (n = 34). The samples were collected from the Russian population in the city of Tomsk (Russia). Using the transmission/disequilibrium test (TDT), a significant association of allele C‐703 IL5 with BA was established (TDT = 4.923, p = 0.007 ± 0.0007). The analysis of 40 individuals with mild asthma and 49 patients with the severe form of the disease revealed a negative association of genotype GG IL4 (OR = 0.39, 95% CI = 0.15–0.99, p = 0.035), and also a trend towards a positive association of the GC IL4 genotype (OR = 2.52, 95% CI = 0.98–6.57, p = 0.052) with mild BA. There was a concordance of the clinical classification of BA severity with the ‘genotype’ (McNemar's X² test with continuity correction constituted 0.03, d.f. = 1, p = 0.859). These results suggest that polymorphisms in the IL4 and IL5 genes contribute to the susceptibility to atopic BA and could determine the clinical course of the disease. Copyright © 2003 John Wiley & Sons, Ltd.

Стратегии профилактики хронических неинфекционных заболеваний: современный взгляд на проблему

Удовлетворенность качеством медицинской помощи: «всем не угодишь» или «пациент всегда прав»?