SOME ASPECTS OF ASSESSING MEDICAL EXAMINATION OF ADULTS IN THE RUSSIAN FEDERATION BEFORE AND AFTER THE COVID-19 PANDEMIC
Authors:   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia, Savchenko Ekaterina 
Published: January 2024

Significance. Preventive activities among population, including active and timely detection of chronic non-communicable diseases, is considered as an effective mechanism to influence public health. A high level of morbidity and mortality, especially among working age population, requires a priority focus on regular check-ups and preventive medical examinations. Pandemic of the new coronavirus infection COVID-19 has made significant changes in the healthcare sector, including in the process of performing medical examinations. The period of restrictions has negatively affected availability of preventive measures. Understanding the extent of the impact of the COVID-19 consequences on the preventive component of the health care organization should become an important issue for the medical community. Evaluation and interpretation of the results of preventive work, including coverage with medical examinations and primary detection of chronic non-communicable diseases, as well as staffing, is an integral part of work of health authorities at all levels. The purpose of the study was to evaluate staffing of departments and offices of medical prevention, coverage of the attached adult population with medical examination, dynamics in primary detection of non-communicable diseases before and after the COVID-19 pandemic. Material and methods. Data of the federal statistical observation form No. 30 "Information about medical organization", as well as forms of the industry statistical reporting No.131/o "Information on health check-ups and medical examination of certain groups of adult population" in the Russian Federation for 2018-2022 are analyzed. Methods of descriptive statistics are applied. Results. In the period from 2018 to 2021, the indicator of staffing of departments and offices of medical prevention with doctors decreased, reaching its minimum in 2020 – 69.5%. In 2022, there was a 1.4% increase compared to 2021, which is still lower than the values of the pre–pandemic period (2019 - 73.8%). The staffing with nurses over a five–year period remained at the level of 81.9 - 86.6%. In 2022, the indicator was 82.9%, the rate of decline in 2018 – 2022 equaled to 2.5%. The minimum level of the implementation of the plan on health check-ups and preventive medical examinations was registered in 2020, that is, during the period of restrictions associated with the COVID-19 pandemic: 48.7% among urban population and 52.6% among rural population. In 2022, the indicator slightly increased (80.2% and 76.8% for urban and rural population, respectively), but did not reach the pre-pandemic values of 2019. The level of the implementation of the in-depth medical examination plan in 2022 doubled compared to 2021 and added up to 84.2 and 78.9% among urban and rural population, respectively. The share of medical examination coverage of the attached adult population in 2022 did not reach the values of the pre-pandemic period and amounted to 29.3%. The lowest coverage was registered in men aged 40-54 – a contingent at risk of premature preventable death. In 2022, the number of newly diagnosed diseases as a result of medical examination was 18.9% less compared to 2019. The primary detection rate was 8010.5 per 100 thousand examined (2019 – 12849.1). The primary detection rate of diseases of the circulatory system in 2022 is below the 2019 indicator – 3136.0 and 3352.7 per 100 thousand examined, respectively. The primary detection rate of malignant neoplasms in 2022 slightly increased and added up to 127.0 per 100 thousand undergone the first stage of check-up and preventive medical examination (2019 – 115.9). The primary detection rate of diabetes mellitus in 2022 was 278.9 per 100 thousand examined, which is 32.3 points higher than the pre-pandemic value. Conclusions. The staffing level of departments and offices of medical prevention in 2022 did not exceed 72.1% for doctor positions, 82.9% for nursing staff positions and failed to reach the pre-pandemic level. The percentage of the implementation of the preventive medical examination plan in the post-pandemic period is lower than in 2019. Coverage of the adult attached population with medical examination in 2022 added up to 29.3% and did not reach the pre-pandemic values, suggesting stagnated implementation of preventive measures. The lowest coverage was registered in men aged 40-54. A higher indicator in this age group is a reserve for reducing mortality. In the post-pandemic period, primary detection rate of non-communicable diseases, which top the mortality structure, has multidirectional dynamics. To determine areas of inefficiency, it is necessary to study both organizational and medical components of the medical examination implementation. Scope of application. Results of the evaluation of medical examination of adults in the Russian Federation before and after the COVID-19 pandemic can be used to make organizational and managerial decisions at the federal and regional levels.