Objective. To study the provision of high-tech medical care in the Russian health care system. Material and methods. Theoretical and methodological analysis of the peculiarities of high-tech medical care provision in the Russian health care system taking into account historical changes in the regulatory-legal landscape and socio-economic conditions in the country was carried out. The main method of research was the analysis of documents (scientific publications 72; normative-legal acts 9). Results. The article considers the main aspects of the organisation of the provision of high-tech medical care to patients in the modern domestic health care system. The authors’ theoretical and methodological analysis of the peculiarities of the organisation of high-tech medical care provision reflects the determinism of the practice of its provision by the historical context of normative-legal regulation of this sphere, the level of digitalisation and informatisation of the health care system development, centralisation and persisting territorial inequality of high-tech medical care accessibility in the country. Conclusion. In the conditions of intensification of digital changes in the health care system, the obvious and expected vector of development is the improvement of accessibility and quality of medical care (including high-tech care), while the pace of technological development and introduction of innovative methods and technologies in the practice of providing medical care to the population allow us to predict a significant expansion of the list of high-tech care already in the short term.

BACKGROUND: Modern strategic planning for the development of the health care system in the region involves regular monitoring of problem areas for the timely identification of emerging problems, as well as monitoring the effectiveness of measures designed to eliminate the identified problems. Based on this, within the framework of the 5th level of medical and sociological monitoring of the results of strategic planning for the development of regional health care, which involves studying the opinions of regional experts, a study was conducted focused on studying the main problems and prospects for the development of the health care system in the Moscow Region on the most important ones from the standpoint of its strategic planning directions. AIM: To determine the degree of relevance of problems for the health care system of the Moscow Region and for the next medium-term strategic planning of measures for its development, as well as to evaluate the indicators from the standpoint of their significance, which will serve as the basis for compiling the archetype of the health care system in the territory of the municipal formation of the Moscow Region in order to adopt further management decisions, including taking into account municipal features. MATERIALS AND METHODS: A survey was conducted of experts from among the heads of regional medical organizations of the Moscow Region, their deputies for the medical profile of activity, as well as the main freelance specialists of the Ministry of Health of the Moscow Region. A total of 126 people were interviewed using formalized structured interviews and questionnaires. RESULTS: In the course of the study, a range of the most pressing problems of the health care system of the Moscow Region was determined today. In addition, activities were identified, the strategic planning of which is most relevant for the formation of the next medium-term program “Health of the Moscow Region”. The study also made it possible to streamline the list of indicators characterizing the archetype of the health care system in the territory of the municipality of the Moscow Region, according to the degree of their importance in making and implementing management decisions in the framework of medium-term strategic planning for health care development. CONCLUSION: The study demonstrated the sustainability of some problems in the health care system of the Moscow Region that currently need to be addressed.

The medical mental health care for patients is provided by different specialists: psychiatrists, psychotherapists, social workers, rehabilitation specialists and psychologists. The lack of interdisciplinary cooperation leads to a disconnection of actions of specialists and a decline in the quality of assistance for patients as a result. This issue can be solved by making a professional platform for interaction and exchange of experience of multidisciplinary specialists. By the way, the development of similar educational programs where knowledge from related fields will be included will help to improve mutual understanding, as well as interaction within the framework of cooperation between these specialists.

ЦЕЛЬ ИССЛЕДОВАНИЯ Изучить возможности модернизации образовательного подхода при подготовке провизоров с учетом их социализации в профессии. МАТЕРИАЛ И МЕТОДЫ Проведен сравнительный анализ мнений учащихся, профессорско-преподавательского состава образовательных организаций города Москвы и сотрудников фармацевтической отрасли о качестве профессиональной подготовки по специальности «Фармация». Исследование проведено методом анкетного опроса экспертов (формализованные интервью) и студентов-провизоров. РЕЗУЛЬТАТЫ Изучение уровня профессиональной ориентированности, а также перспектив профессиональной социализации выпускников фармацевтических факультетов вузов выявило необходимость более тесного сотрудничества образовательных организаций и предприятий отрасли в ходе подготовки специалистов с целью по возможности раннего погружения учащихся в профессию и сохранения кадрового потенциала фармацевтической отрасли. Исследование траекторий профессионального становления и социализации сотрудников фармацевтической отрасли свидетельствует о доминирующем наполнении предприятий отрасли специалистами смежных специальностей, приобретающих специальные фармацевтические знания непосредственно в процессе трудовой деятельности. Выявлена потребность предприятий в высокопрофессиональных кадрах с высшим фармацевтическим образованием, обладающих знаниями в смежных специальностях. Исследование потребности фармацевтической отрасли в подготовке кадров подтверждает, что современный уровень развития фармации и увеличение доли биотехнологических предприятий на отраслевом фармацевтическом рынке привели к необходимости модернизации образовательных программ в тесном взаимодействии профильных образовательных организаций с предприятиями отрасли. Единые требования к выпускникам профильных учебных заведений, сформированные профессиональным сообществом, наряду с хорошей фундаментальной подготовкой провизоров позволят молодым специалистам легко адаптироваться к происходящим изменениям в профессиональной сфере и найти применение своим знаниям и умениям на биотехнологических предприятиях, в исследовательских компаниях и в других организациях фармацевтической отрасли. ЗАКЛЮЧЕНИЕ Полученные результаты формируют целостную картину восприятия современного высшего фармацевтического образования с различными сторонами учебного процесса и позволяют аргументировать изменения, назревшие в высшем фармацевтическом образовании. Результаты исследований внедрены в деятельность ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет) и ряда частных фармацевтических компаний московского региона.

It is well-known that the duration of medical rehabilitation after injuries depends on the effectiveness of resolving anatomical and physiological disorders in patients. A fracture of the distal metaepiphysis of the radius in patients over 60 years can have a pronounced stressful effect on the body, affecting the physiological changes in the body and the recovery period. Objective. To perform physiological control of rehabilitation measures based on different tactics of physiological recovery in women of mature age after a fracture of the distal metaepiphysis of the radius. Material and methods. The study was conducted at the municipal budgetary health care institution in Chelyabinsk and included 50 females (average age 63.5±1.5 years) diagnosed with a fracture of the distal metaepiphysis of the radius. The patients were allocated to the control and main groups of 26 subjects each. Subjects in the main group performed a set of self-relaxation exercises based on the post-isometric muscle relaxation rehabilitation technique, and subjects in the control group performed a set of traditional therapeutic exercises. The effectiveness of exercises was evaluated on days 3, 7, and 14. Results. The developed and applied self-relaxation exercises based on the post-isometric muscle relaxation technique were more effective than traditional therapeutic exercises. It is shown that for the successful recovery of the function of the injured limb, physiological control is also necessary during the entire medical rehabilitation, which depends on the severity of the injury, the duration of the disease, the age of the patient, and the presence of comorbidities. Conclusion. Self-relaxation exercises after an upper limb injury provide a favorable rehabilitation effect in a shorter period. In women with an upper limb injury, post-immobilization dynamic monitoring of cardiovascular and respiratory systems is reasonable for prophylactic purposes.

Objective. To analyze the results of developing a neural network dialogue system for the formation of relevant responses to written requests of the population to a medical institution. Material and methods. The study was conducted at the Volga District Medical Center of the FMBA of Russia. The authors used a pre-trained Bidirectional Encoder Representations from Transformers (BERT) model. As part of the study, a phased approach to fine-tuning the BERT model was used: adaptation in everyday vocabulary (Yandex/geo-reviews), optimization using loss functions (TripletLoss, ArccosMarginLoss), and classification using the SVM method. The dataset (2.623 records) was divided into training and test samples in a proportion of 8/2. Results. Citizens’ requests were classified using a feedback database of 2.623 records and divided into 18 categories. Categories with fewer than 20 entries were removed due to a lack of representativeness. It was found that messages have a substantial semantic overlap between categories. A single email could simultaneously contain several requests belonging to different categories. When the entry contained several similar but multidirectional statements, it resulted in a model failure. To avoid this, it was decided to use sets of templates that the model could offer the operator to facilitate the preparation of a response to a patient’s request. Conclusion. The study results present compelling evidence that it is currently not feasible to completely exclude human participation in the full-fledged dialogue between artificial intelligence and a patient. The technological imperfection of modern artificial intelligence platforms does not yet allow solving the problems of subtle differentiation of a semantically complex message and its emotional coloring, thus preventing their wide autonomous use. However, they can already significantly facilitate the work of medical personnel in remote interaction with the served population.