Epidemiology & Public Health

The high effectiveness of endovascular care in acute myocardial infarction has been scientifically proven and is the rationale for increasing its territorial and economic accessibility to the population at the regional level. Aim: To develop the organizational and methodological foundations of the endovascular care system at the regional level in Russia. Material and methods: The development of organizational and methodological foundations of the endovascular care system at the regional level was carried out in the basic economically developed, densely populated (more than 7 million people) subject, in which there was no endovascular care. The methods of statistical analysis (correlation and regression), mathematical modeling, analogy and synthesis are used. The results were evaluated based on the analysis of the effectiveness of the implementation of the endovascular care system. Results: The organizational and methodological basis of the endovascular care system was developed, which includes four blocks: need (analysis of the general and special incidence of diseases of the circulatory system), standardization (development of medical and economic standards for endovascular care), safety (assessment of the safety of endovascular interventions and the quality of life of patients) and systematization (development of an organizational-functional model). Analysis of the results of the implementation of the developed fundamentals of endovascular care at the regional level for the period 2008 - 2017 evidence of their effectiveness, which was characterized by: the organization of 10 PCI centers, the development and implementation of 12 medico-economic standards of endovascular care, the high intensity of  hospitalization of patients with myocardial infarction in the first 6-12 hours for PCI (more than 80%), and a decrease in hospital mortality from acute myocardial infarction by 2.75 times (from 22% to 8%; p<0.05), a decrease in the average duration of treatment of patients with acute coronary syndrome in the hospital by 2 times (from 14 to 7 days; p <0.001), improved average bed occupancy rate from 305 to 340 (p <0.001) and an increase in bed turnover from 29.6 to 53.9 (p <0.001). Conclusion: The introduction of modern organizational and methodological principles of the organization of endovascular care at the regional level provides high quality medical care.