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Российская методика по оценке предотвратимой смертности населения
The article presents the Russian methodology for assessing avoidable mortality. Based on the analysis of existing scientific data and approaches of other countries to the definition of preventable mortality, the criteria of preventable mortality, taking into account the peculiarities of the Russian health care system, are proposed. The criteria were developed jointly with leading federal experts in the field of health care, including chief non-staff specialists of the Ministry of Health of Russia. The upper age limit of avoidable mortality was defined and set at 78 years, which corresponds to the national development goals of the Russian Federation. The methodology includes 147 items for various causes of death and provides for the division of avoidable mortality into preventable and treatable mortality, specifying the proportions for 17 groups of causes of death. The concept of avoidable mortality is presented as a way of assessing the quality and objective capabilities of the health care system. Therefore, the methodology can be used as a tool for assessing the quality of medical care, an indicator of the effectiveness of preventive measures and a marker of progress in achieving the national goal of improving public health. The introduction of the methodology will make it possible to identify priority areas of prevention, assess the effectiveness of treatment and diagnostic measures, monitor the dynamics of avoidable mortality and form targeted programmes to reduce mortality, as well as to identify realistic reserves for reducing mortality by reducing avoidable mortality. In particular, it seems necessary to study avoidable mortality in the regional context, which will make it possible to assess not only the national reserves of mortality reduction, but also individual reserves for each region. At the same time, the analysis of regional differences in avoidable mortality will help to better understand the factors of interregional differences in mortality in general.