The article describes the main problems of managing medical care for industrial enterprises’ staff, including remote industrial sites (RIS), and the options for health care for this category of the employed population. The search for publications was conducted on all available bibliographic and abstract databases (The Russian Science Citation Index, Scopus, Web of Science, CyberLeninka, eLibrary, PubMed) containing the Russian publications. The data of industrial injuries and the country’s working population’s occupational morbidity in recent years are given. As a result, the authors point out the need to transition to risk management in the workplace. The disadvantages of the assessment system of the health status of employees during routine medical examinations are identified. The main problems of creating a medical support system for RIS workers were analyzed, and the relevance of creating a remote industrial healthcare system in the Russian Federation is substantiated. The paper presents the existing disadvantages in the current legislative framework. In particular, it is established that today in Russia, there is no standard for the provision of medical care for RIS workers, no algorithm for the actions of medical staff, no sanitary rules for managing health posts at RIS. The characteristics of the problems in medical evacuation and the ways of their solution are presented. The necessity of the introduction of telemedicine technologies and conditions for ensuring this process nationwide is substantiated. The spectrum of factors negatively affecting the health of RIS workers is characterized. The need to take these factors into account when creating a health care system for this category of the working population is substantiated.

Introduction. The organization of medical assistance for employees of remote industrial facilities is a highly pressing task, and the role of medical evacuation in the health care system can hardly be overestimated. There is currently no unified medical evacuation system. There is no data on the structure of the reasons for evacuations and economic justification for the required amount of funding for this area in Russia. Purpose. The assessment of the structure of the reasons for medical evacuations of the personnel from remote industrial facilities and their possible relationship to seasonality, the profile of the enterprises, and the age of workers. Material and methods. Considering that men constitute most industrial facilities’ personnel, the analysis of 1,823 evacuations among male personnel (1,159 planned and 664 emergencies) was carried out. The structure of the reasons for evacuations was studied depending on the age, season, and industrial enterprise profile. The χ2 Pearson criterion (significance level p <0.05) was used to assess the significance of differences between analyzed indices. Results. In the structure of all evacuations of the personnel of remote industrial facilities, diseases of the circulatory system are the leading reason for evacuations, followed by injuries and poisoning, diseases of the digestive system and respiratory diseases. The main reason for emergency evacuations is injuries and poisoning. In the group of workers under 39 years old, injuries and poisoning, diseases of the digestive system and diseases of the circulatory system take the first three positions. In the more senior age groups, diseases of the circulatory system prevail, injuries and poisoning take second place, and digestive diseases take third place. Conclusion. The main directions in improving the health care system and maintaining the health of the personnel of remote industrial facilities include the development of the legal framework for activities in the field of remote health care, the organization of the unified state system of medical evacuations, the development and the implementation of telemedicine technologies, the organization of educational courses and training programs for medical professionals in the field of remote health care.