Background. The implementation of individual methods of high-tech medical care (HTMC) with methods of specialized medical care within the framework of a phased transition to payment methods by diagnostic-related groups (DRGs), on the one hand, significantly expanded the availability of HTMC methods for the population. Still, it created a situation with duplication of individual treatment methods in the list of HTMC types and DRGs. Amendments to the Order of the Ministry of Health of the Russian Federation (MH RF) of August 1, 2017 No. 484n, regulating the revision of HTMC types list in terms of excluding treatment methods and (or) HTMC types in case of their duplication in the context of HTMC groups and/or DRGs, marked the beginning of large-scale work in this area and required methodological ensuring the processes of forming HTMC types list, including in terms of its revision.Objective: development of a methodological approach to the formation of HTMC types list (using the example of the list for 2023). Material and methods. An analysis of legal documents regulating the HTMC availability in the Russian Federation was carried out, including the list of medical services approved by the Order of the MH RF of October 13, 2017 No. 804n, clinical recommendations for certain nosological entities, the International Classification of Diseases (10th revision), methodological recommendations on ways to pay for medical care at the expense of the compulsory health insurance (CHI) and appendices to them (decoders of DRGs for payment of medical care provided in inpatient and daytime hospital conditions), posted on the official website of the Federal CHI Fund. The frequency of the use of certain HTMC methods and DRGs was analyzed on the basis of impersonalized information from the database of registers of bills for specialized medical care, including HTMC for 2021–2022.Results. A methodological approach to the revision of HTMC types list was developed. It included its primary analysis, expert discussion of the obtained results, consideration by the Interdepartmental Council of the MH RF of proposals agreed with experts on each HTMC method submitted for discussion, followed by a decision on the appropriateness of the proposed changes, and recalculation of the standard of financial costs for HTMC and/or basic tariff for DRGs.Conclusion. The proposed methodological approach makes it possible to unify the process of revising the HTMC types list, including the exclusion of duplicate treatment methods and/or HTMC types in the sections of HTMC list types and/or in DRGs, as well as treatment methods missing in clinical recommendations, etc. in order to bring the HTMC types list in accordance with legal documents regulating the provision of medical care in the Russian Federation.

Background. In 2021, new clinical guidelines for the treatment of chronic hepatitis C virus (HCV) in adults were published that did not contain interferon drug therapy regimens. Current therapy of chronic HCV is based on modern drugs of direct-acting antivirals (DAA). In this regard, the model of diagnosis-related groups (DRG) with the use of interferon-containing drugs as etiotropic therapy, which has been in effect until now, has lost its relevance and cannot be used to pay for cases of medical care for chronic HCV within the framework of the Program of State Guarantees of Free Medical Care to Citizens for 2023 and for the planning period of 2024–2025 (PSG). Objective: to improve the DRG model to pay for medical care for chronic HCV in a day hospital based on current clinical recommendations.Material and methods. Regulatory legal documents on the subject of the study, proposals and expert opinions of specialists, as well as feedback from public organizations, including patients, regarding the payment of medical care for chronic HCV, sent as part of a public discussion of the draft PSG, were studied. For the calculations were used: the current version of the clinical recommendations "Chronic viral hepatitis C"; impersonal personalized information of the database of registers of bills for payment for medical care for 2020–2021; the state register of manufacturers' maximum selling prices for medicines included in the list of vital and essential drugs.Results. A DRG model was developed to pay for medical care during drug therapy of chronic HCV, including for children. When calculating the model, the cost of medicines, patient days and the principles of accounting for the duration of hospitalization were updated.Conclusion. The developed DRG model to pay for medical care for chronic HCV in a day hospital with the use of drug therapy regimens with DAA recommended by clinical guidelines, including for children with HCV, contributes to improving the effectiveness of the system of payment for medical care provided as part of the implementation of the PSG and accessibility of medical care for this contingent of patients.

On October 19, 2022, the Council of Experts considered and discussed a number of issues related to the treatment of patients with infantile hemangioma in the Russian Federation.