Regional differences in cardiac mortality rates in Russia: the role of statistical features

Драпкина, О. М.; Samorodskaya, I. V.; Yavelov, I. S.; Кашталап, В. В.; Barbarash, O. I.

doi:10.15829/1728-8800-2021-2928

Cited by 13 publications

(6 citation statements)

References 17 publications

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“…Всемирная организация здравоохранения указывает, что качественные услуги здравоохранения должны быть эффективными, безопасными, своевременными, справедливыми, действенными, ориентированными на потребности людей. Качественные услуги распространяются на укрепление здоровья, профилактику, лечение, реабилитацию и паллиативную помощь 1 . Следует понимать, что высокое качество оказания медицинской помощи -одно из слагаемых успешного достижения поставленных перед здравоохранением задач снижения смертности и увеличения продолжительности жизни.…”

Section: Discussionunclassified

“…По данным Всемирной организации здравоохранения, ежегодно в мире от сердечно-сосудистых заболеваний (ССЗ) умирают 17,9 млн человек, что составляет 32% от всех смертей 1 . В РФ ССЗ зани-мают первое место в структуре общей смертности населения, становятся одной из основных причин инвалидизации населения и, как следствие, сопровождаются значительными экономическими потерями как для государства, так и для общества в целом 2 [1,2].…”

Section: Introductionunclassified

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Quality and availability of health care for patients with cardiovascular diseases. Results of sociological research

Глезер

Polyarnaya

Fomina

et al. 2023

Cardiovasc Ther Prev

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Aim. Based on the results of a sociological survey of patients, to assess quality and availability of health care for cardiovascular diseases (CVDs) in 2020-2021 in the Russian Federation.Material and methods. In August-September 2021, 5159 patients with CVDs from 76 Russian regions were interviewed. Questionnaire (Google form) assessed the change in health care provision over the past two years, the availability of medicine provision, the prevalence and reasons for discontinuation of treatment, as well as the difficulties faced by patients.Results. Improvement in health care provision were assessed by 47,6% of the surveyed patients with CVD, worsening — by 16,6%, and 23,7% did not noted any changes. Improvements regarded diagnosis promptness (29%) and timeliness of treatment (28,5%), availability of subsidized medicines (25%) and better patient routing (21%). However, 37% of respondents did not see any improvements in health care system, or found it difficult to answer. The acute problem of access to diagnostics was considered by 24%, inaccessibility of subsidized medicines — by 17%. In addition, 24% of respondents had difficulties in obtaining specialized cardiology care in the polyclinic and 18% had difficulty in obtaining high-quality medical rehabilitation for CVD.Conclusion. In order to increase public satisfaction with the quality of care, public awareness on health maintenance and patients’ rights to receive care should be improved. In addition, possible barriers to obtaining health care should be eliminated, while consultative and diagnostic assistance and subsidized drug provision should be facilitated for receiving.

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Section: Discussionunclassified

Section: Introductionunclassified

Quality and availability of health care for patients with cardiovascular diseases. Results of sociological research

Глезер

Polyarnaya

Fomina

et al. 2023

Cardiovasc Ther Prev

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“…Количественные данные не могут дать ответа на вопрос о причинах такого явления. В предыдущих статьях и мы, и другие авторы уже указывали на вероятную большую значимость такого фактора, как разные подходы к определению ППС [12]. Несмотря на рекомендации о необходимости использовать универсальные критерии диагностики ИМ, нет уверенности в том, что при заполнении медицинского свидетельства о смерти (МСС) используются именно эти критерии.…”

Section: Discussionunclassified

Mortality rates of acute types of coronary artery disease and sudden cardiac death in the Russian regions in 2019-2021

Samorodskaya¹,

Бубнова²,

Akulova³

et al. 2023

Cardiovasc Ther Prev

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Aim. To compare standardized mortality rates (SMR) from acute types of coronary artery disease (CAD) and sudden cardiac death (SCD) with an assessment of their regional variability in the Russian Federation in 2019-2021.Material and methods. Rosstat data on the average annual population and the number of deaths in one-year age groups for 2019-2021 in 82 Russian subjects from acute types of CAD and SCD were analyzed using following ICD-10 codes: I21.0-9 (acute primary) myocardial infarction (MI), I22.0-9 (recurrent MI), I20, I24.1-9 (other forms of acute coronary artery disease), I46.1 (SCD). SMR was calculated based on the European standard per 100,000 population. Average regional SMR values (M±SD), coefficients of variation (СV), nonparametric Wilcoxon T-test with Bonferroni adjustment were calculated (differences were considered significant at р<0,05).Results. The average regional values of SMR from the sum of causes (acute types of CAD and SCD for 2019, 2020 and 2021) did not change significantly and amounted to 52,3±33,72; 53,84±36,17; 53,58±34,55, respectively. The annual increase in the average regional SMR for this period was noted from acute MI — 23,59±11,01; 24,85±10,92; 25,73±11,38, and other OF CAD — 19,47±26,17, 19,78±27,45; 20,54±26,79, respectively, in 2019, 2020 and 2021. A significant decrease in SMR occurred only from recurrent MI: from 7,19±5,38 to 6,97±5,97 in 2019-2020 (p=0,048) and to 4,99±4,25 in 2021 (p=0,023 to 2020). In 18 constituent entities of the Russian Federation, an annual decrease in SMR was noted, and in the rest — multidirectional changes. The increase in SMR from acute MI took place in 23 subjects of the Russian Federation with a minimum CV in 2020 and 2021 (44%). The maximum CV for SMD was recorded in 2021 (169%).Conclusion. Mortality from acute types of CAD and SMD for 2019-2021 in the Russian Federation was characterized by a stable level and high regional variability. The problem of improving the criteria for establishing acute types of CAD and SMD as the initial cause of death remains relevant in the absence or insufficiency of data for universal criteria for MI.

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“…В последние несколько лет неоднократно обсуждались проблемы корректного статистического учета причин смерти от отдельных причин и групп заболеваний [1][2][3][4][5]9]. Однако до настоящего времени это не оказало значимого влияния на ситуацию с определением ППС и кодированием причин смерти.…”

Section: Discussionunclassified

“…о среднегодовой численности населения и числе умерших в однолетних возрастных группах в соответствии с КНПСР, были отобраны кардиологические причины смерти. Обоснование подходов к формированию групп подробно описано в предыдущей статье [9]. спублики Бурятия, Ингушетия, Сахалинская, Иркутская, Кировская, Калужская области, Севастополь, Ставропольский край и Чукотский автономный округ) на фоне роста СКС от всех причин.…”

Section: материал и методыunclassified

Dynamics of Regional Mortality Rates From Cardiac Causes in Russia 2019–2020

Драпкина

Samorodskaya

2022

Kardiologiia

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Aim To analyze the dynamics of standardized mortality ratios (SMR) (2019–2020) for the cardiological causes indicated as the primary (original) cause of death, in regions of the Russian Federation, based on the RF State Statistics Service Brief Nomenclature of Causes of Death (RFSSS BNCD). Reports have indicated substantial changes in the indexes and structure of mortality since the beginning of the COVID-19 pandemic in many countries.Material and methods RFSSS data on numbers of deaths were analyzed according to BNCD and mid-year population in single year of age groups in 2019 and 2020. SMRs were determined for 23 cardiological causes of death listed in the BNSD in a separate line; the average regional SMR value and the standard deviation were provided; and SMRs were compared both among 4 groups (with a previously described method) and by 23 RFSSS BNCD causes using the Wilcoxon test.Results In 2020 vs. 2019, the mean regional SMR for cardiological causes increased by 12.07±9.86 % (from 301.02±77.67 to 336.15±84.5 %; р<0.0001). Decreases in SMR were found in 9 of 82 regions; however, only in two of them (the Republic of Ingushetia and the Sakhalin Region), SMR was decreased for all 4 groups of causes. In both 2019 and 2020 (60.9±13.8 and 62.5±12.8 %, respectively), the highest proportion of deaths was related with the 1st group of causes (chronic ischemic heart disease, IHD), with an increase in SMR of 18.66±33.28 % (р<0.0001). Increases in SMR were found in 75 regions while in the other regions, decreases in SMRs were observed. For the 2nd group of causes (myocardial infarction, other acute forms of IHD, sudden cardiac death), the mean regional SMR increased in 2020 by 3.2±18.1 % (р=0.3). Increased SMRs were noted in 54 regions. The proportion of the 2nd group in cardiological mortality was 17.3±9.7 % in 2019 and 16.1±9.6 % in 2020. The mean regional SNR for the 3rd group of causes (heart defects, myocardial diseases, etc.) increased in 2020 by 11.6±23.1 % (р=0.006). The mean regional proportion of causes for this group did not significantly changed compared to 2019 (17.5±8.2 and 17.1±7.3 %, respectively); however, the contribution of this group was greater than the contribution of the 2nd group. Increases in SMR were observed in 65 regions, while the contribution of causes related with arterial hypertension did not significantly change. Significant mid-regional differences in SMR values, dynamics of SMRs for different causes, and increases in the coefficient of variation were noted for almost all causes of death. Significant differences between 2019 and 2020 were found for 3 of 23 causes: other forms of chronic IHD (decreased SMRs in 15 regions and increased SMRs in the others), atherosclerotic heart disease (decreased SMRs in 38 regions), and alcoholic cardiomyopathy (decreased SMRs in 28 regions).Conclusion During the COVID-19 pandemic, the SMR for cardiological causes was increased. Considerable regional differences in values and dynamics of SMR for individual causes call for attention to the unification of the criteria for clinical diagnosis.

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Regional differences in cardiac mortality rates in Russia: the role of statistical features

Cited by 13 publications

References 17 publications

Quality and availability of health care for patients with cardiovascular diseases. Results of sociological research

Quality and availability of health care for patients with cardiovascular diseases. Results of sociological research

Mortality rates of acute types of coronary artery disease and sudden cardiac death in the Russian regions in 2019-2021

Dynamics of Regional Mortality Rates From Cardiac Causes in Russia 2019–2020

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