INTRODUCTION: Identification of morbidity (based on requests) and the population’s need for dental care optimizes the planning and distribution of compulsory health insurance (CHI) funds between medical organizations at the regional level. However, due to a decrease in the population’s demand for medical care in the context of the new coronavirus infection (Corona Virus Disease 2019, COVID-19), the dynamics of the provision of dental care and the structure of dental morbidity taken into account in the compulsory medical insurance system, have changed. AIM: To study the structure and dynamics of the provision of dental care in the period 2018–2021 (pre-pandemic and COVID-19 pandemic period) based on the volume of dental care paid for in the compulsory medical insurance system provided to citizens of the Ryazan region (RR). MATERIALS AND METHODS: The analysis was carried out on the basis of registers of bills accepted for payment submitted by medical organizations, taking into account the results of control and expert measures. All completed cases of treatment of insured persons with dental diseases in medical organizations of the Ryazan Region for 2018–2021 were selected for study according to territorial compulsory medical insurance programs. RESULTS: In the structure of outpatient primary health care in 2021, cases of its provision in the ‘Dentistry’ profile amounted to 7.40 ± 0.10%, taking 3rd place; the total number of cases of providing medical care to patients with this pathology decreased by 5.60% compared to 2018. Despite the reduction in the volume of primary dental care, the volume of dental examinations of the population of the RR increased by 30.46%. There was also a 34.08% reduction in completed cases of treatment of chronic periodontitis (p 0.02). For the 2018–2021 period 73,049 medical and economic examinations (MEE) and 1,626 examinations of medical care quality (EMCQ) were carried out, and 1,966 violations were identified (1,316 based on the results of the MEE and 650 based on the results of the EMСQ). The vast majority of these concerned non-compliance with standards of care and clinical guidelines. CONCLUSION: The results of the study indicate a reduction in the number of cases of insured persons seeking medical care for dental diseases during the COVID-19 pandemic. Owing to the approval of Order No. 231n of the Ministry of Health of Russia of March 19, 2021, obliging medical insurance organizations to carry out control and expert measures in each medical organization in a certain amount of dental care cases accepted for payment, the number of examinations has increased, and, as a result, the identification of violations in the provision of dental care.

AIM: This study aimed to investigate the dynamics of the volume of medical care (MC) provided to the population within the territorial program of compulsory medical insurance (CMI). This study also aimed to examine the lethal outcomes of insured individuals with respiratory diseases (RD) for 5 months in 2020 and 5 months in 2019 in the Ryazan Region during the COVID-19 pandemic. MATERIALS AND METHODS: Analysis was carried out on the basis of the paid registers of the accounts submitted by medical organizations to medical insurance organizations. These accounts were grouped in accordance with the order of the Federal CMI Fund No 104 On Establishment of the Form and Procedure for Reporting on Cases of Providing MC and the Results of Expertise of the Quality of MC dated June 04, 2018. In this study, all the completed cases of the treatment of the insured individuals with RD (ICD-10 codes: J00-J99) in the medical organizations of the Ryazan Region in 20192020 within the compulsory medical insurance were selected. The obtained data were statistically analyzed using the Microsoft Excel application package (Microsoft, USA) and descriptive statistics. RESULTS: The completed treatment cases of the insured individuals with RD in 2020 were categorized according to the age of patients, nosological form, and conditions for the provision of MC. They had different dynamics of growth/decline relative to the same period in 2019. In the structure of the cases of the MC provision, RD accounted for 13.2% (third place). This tendency was observed in the group of patients aged 60 years (7.8%). In patients aged 1860 years, the proportions of RD (18.0%) and diseases of the digestive system (18.1%) were higher than those of the diseases of the circulatory system (14.2%). The total number of cases of the MC provision to patients with this pathology for 5 months in 2020 decreased by 12.9% compared with that for 5 months in 2019 (11.3% in the age group of 1860 years and 16.6% in individuals aged 60 years). Despite the 38.3% decrease in the number of hospitalizations, the number of the completed cases of specialized MC for pneumonia increased by 27.7% (43.9% in the age group of 1860 years and 11.4% in the age group of 60 years). The comparative analysis of 5 months in 2020 and 2019 showed a 57.1% increase in deaths among patients aged 60 years in the provision of specialized MC and a 20.0% reduction among individuals aged 1860 years. CONCLUSION: The number of insured individuals seeking MC for RD increased during the COVID-19 pandemic, and the level of hospital lethality was low. Therefore, the organizational level of MC in the region was high, and medical organizations were adequately prepared for emergency situations with the preserved provision of high-quality MC.

Significance. The article examines the basic economic principles of capitation financing of primary health care and features of the practical application of this payment method within the compulsory health insurance system in the Russian Federation. Purpose. To develop and test a regional model of allocating reserved capitation funds based on the achievement of planned medical service volumes and changes in mortality among the registered population. Material and methods. The article has analyzed methodological recommendations on the methods of paying for medical care at the expense of compulsory health insurance funds and the results of assessing the effectiveness of medical organizations in the Ryazan Region, with registered population and funded on a per-capita basis in 2024-2025. The article uses methods of economic modeling, statistical analysis, and expert evaluation. Results. An original innovative methodology has been proposed and tested that enables accurate accounting of planned medical care delivery volumes and mortality indicators among the registered population when distributing reserved compulsory health insurance funds allocated for capitation financing. Conclusion. The use of a per capita method of paying for primary health care with due regard to performance effectiveness, economically focuses the medical organization on the priority of preventive measures, contributing to the reduction in morbidity and mortality among the registered population. The proposed model demonstrates high social significance and can be used to improve regional healthcare management systems. Keywords: capitation financing; primary health care; economic efficiency; compulsory health insurance.