BACKGROUND: The World Health Organization considers diabetes mellitus as a significant public health problem, including this disease as one of the four priority noncommunicable diseases. Over the past few decades, the prevalence of diabetes has been steadily increasing and represents a significant threat to the public health of the world’s population. In connection with the territorial features of residence and the availability of medical care to residents of urban and rural areas, studies that include an analysis of the incidence of diabetes mellitus, disability and mortality of the urban and rural population from complications of this disease are one of the important mechanisms for monitoring the health status of the population, which predetermines the improvement and implementation strategies aimed at improving the demographic situation.AIM: To conduct a comparative retrospective analysis of the health indicators of patients with type 1 and type 2 diabetes mellitus living in urban and rural areas of the Saratov region.MATERIALS AND METHODS: Information on life expectancy, morbidity, complications, causes of disability, direct causes of death in patients with type 1 and type 2 diabetes mellitus living in the Saratov region in urban and rural areas was obtained from the Federal Register of Patients with Diabetes; information on the urban and rural population of the Saratov region was obtained from official statistical sources published on the website of the Federal State Statistics Service. Mathematical, statistical and analytical research methods were used. Statistical data processing was carried out using the Microsoft Excel 2019 program. The significance of the difference between the average and relative values was assessed using the Student’s t-test. The presence of a relationship between the signs was determined using the Pearson coefficient. The Mann-Whitney U-test was used to compare populations by quantitative characteristics. The significance level was determined at t>2 and p<005. Data were presented as P ± m, where P is the relative value and m is its standard error, and M ± m, where M is the mean value and m is its standard error.RESULTS: A higher average life expectancy was noted for people with type 2 diabetes, regardless of place of residence, in comparison with the same indicator in the Saratov region. The average life expectancy of patients with type 1 diabetes is 18 years lower than in the Saratov region for those living in urban areas and 17 years for rural residents. There is an excess of the levels of primary and general morbidity in people suffering from type 1 and 2 diabetes and living in rural areas over the same indicators of urban residents. The main causes of death in both urban and rural patients with type 1 and 2 diabetes are: chronic cardiovascular insufficiency, cerebrovascular accident and acute cardiovascular diseases. Disability rates in patients with type 2 diabetes living in urban areas are lower than in rural areas.CONCLUSION: Analysis of data from the Federal Register of Patients with Diabetes Mellitus in the Saratov Region showed high levels of primary and general morbidity, disability and mortality in patients with type 1 and 2 diabetes living in rural areas. Also, frequently occurring complications from the cardiovascular system were identified in all patients with type 1 and type 2 diabetes, regardless of the place of residence. The relationship between the levels of morbidity, mortality, disability, the incidence of complications and the place of residence of patients with type 1 and type 2 diabetes is not statistically significant.

The purpose of the study is to identify the reasons for the low availability of helth care to the population of municipal districts of the Saratov region. Material and methods. For the study, official data from the Federal State Statistics Service, the Central Research Institute for the Management and Informatization of Healthcare of the Ministry of Health of the Russian Federation and the Unified Interdepartmental Information and Statistical System for 2014-2019 were taken. The optimal volumes of health care in inpatient and outpatient settings were calculated in accordance with the orders of the Ministry of Health of the Russian Federation and the Decrees of the Government of the Russian Federation. Results. During the study in the region, the reasons for the low availability of health care to residents of municipal districts were identified: lack of human resources in municipal medical organizations, low population density of municipal districts, low recommended staffing standards for specialists in accordance with the Procedures for organizing medical care. Limitations. The main demographic indicators, indicators of resource provision and performance indicators of medical institutions in the Saratov region for 2014-2019 were studied. A comparative analysis of the cost of training programs for highly qualified personnel in the residency of the Saratov State Medical University named after V.I. Razumovsky of general practitioners and the most demanded specialties in municipal outpatient medical organizations in the region. Conclusion. As a result of the study, the reasons for the low availability of health care to the population of the municipal districts of the region were identified and possible ways to overcome them were proposed.

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The article presents the results of study of quality of life of patients of able-bodied age with arterial hypertension. The study was carried out om the basis of ambulatory polyclinic institutions of Saratov in 2013-2015. The questionnaire WHOQOL-100 was applied. The respondents with arterial hypertension had statistically reliable decreasing of total index of quality of life, index of total value of life perception and also indices of quality of life in such areas as "Physical", "Level of Independence", "Environment" that testify somatic determination of index of quality of life of the given areas. The impact is established related to the level of incomes and related deprivations on both total index of quality of life of patients with arterial hypertension and indices of quality of life in particular sections of questionnaire WHOQOL-100 (mainly such sections as "Level of Independence", "Psychological" and "Physical" sections). This occurrence substantiates assumption about social determination of quality of life of patients with arterial hypertension.

The article presents analysis of accessibility of medicinal treatment according to standards of medical care for able-bodied patients with arterial hypertension. The inadequate medicinal support in case of out-patient treatment of population not included to benefit categories turned out one of problems in the area of circulation of medications in the Russian Federation. Until now, arterial hypertension positioned to be among diseases without any public compensation of costs for outpatient treatment. The actual study substantiates that out-patient treatment with its average costs according established standards makes up to 964.2 rubles per month is inaccessible for 78% of respondents of able-bodied patients included into study.