IMPACT OF ACCESS TO SPECIALIZED, INCLUDING HIGH-TECH MEDICAL CARE FOR PATIENTS WITH THE CORONARY ARTERY DISEASE ON CORONARY ARTERY DISEASE MORTALITY IN THE RUSSIAN FEDERATION

Aim To assess the effect of the availability of specialized, including high-tech, medical care for patients with ischemic heart disease (IHD) on mortality from IHD in the Russian Federation. Material and methods To achieve the predetermined goal, we used cointegration of time series characterizing the mortality from IHD and the availability of specialized, including high-tech, medical care for patients with IHD in the Russian Federation for the period from 2015 to 2021: availability of cardiac beds; availability of cardiac surgery beds; availability of beds in regional vascular centers (RVC); availability of beds in primary vascular departments (PVD); availability of cardiologists in polyclinics; availability of cardiologists in hospitals; availability of cardiovascular surgeons (CVS) in hospitals; availability of interventional radiologists for endovascular diagnosis and treatment (EVDT) in hospitals; availability of therapeutic procedures of percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS); availability of elective PCI procedures; availability of coronary artery bypass grafting (CABG). Results Cointegration tests showed a relationship between IHD mortality and the availability of beds at RVCs and PVDs and of CABG operations. Furthermore, an increase in the availability of RVC beds by 1 unit in each period results in a decrease in IHD mortality by 22.8 per 100,000 population during the year; an increase in the availability of PVD beds by 1 unit in each period results in a decrease in IHD mortality by 64.4 per 100,000 population during 2 years; and an increase in the availability of CABG by 1 unit in each period of time results in a decrease in IHD mortality by 34.8 per 100,000 population during 2 years. Conclusion Thus, the most promising directions for concentrating healthcare resources to quickly reduce IHD mortality are the further deployment of a network of RVCs and PVDs, as well as increasing the number of CABG operations.