Передовая статья 389http://journal.pulmonology.ru Показатели смертности населения (ПСН) по при чине болезней органов дыхания (БОД) являются важными индикаторами качества медицинской по мощи, включающей профилактику, диагностику и лечение заболеваний, динамическое наблюдение и реабилитацию больных.БОД стабильно занимают лидирующее место в структуре общей заболеваемости населения Российской Федерации (РФ), составив в 2014 г. 29 455 225 случаев (54,2 % всех заболеваний) у детей, 3 403 (33,2 %) -у подростков, 23 394 842 (13,6 %) -у взрослых. В структуре заболеваемости БОД в 2014 г. на пневмонию приходилось 199 035 случаев у детей, 17 727 -у подростков, 398 564 -у взрослых (Статис тическая форма № 12 «Сведения о числе забо леваний, зарегистрированных у пациентов, про живающих в районе обслуживания медицинской организации» (2014); Приказ Росстата «Об утвержде нии формы от 25.12.14 № 723»).Отмечается тенденция к росту частоты БОД. Особенно это касается пневмоний, хронической обструктивной болезни легких (ХОБЛ), бронхиаль ной астмы (БА) и т. п. В России ПСН по причине БОД занимают 5 е место среди основных причин смерти, однако они выше показателей в европейских странах, Великобритании и США.Целями настоящего исследования явились ана лиз ПСН России от БОД в 2014-2015 гг. и разработ ка мер, направленных на ее снижение. Материал и методы РезюмеПроведен анализ показателей смертности населения (ПСН) России от болезней органов дыхания (БОД) за 2014 г. и за январь сентябрь 2015 г. по данным официальной статистической информации Минздрава России и Росстата. В 2014 г. в России (без учета Крымского федерального округа) ПСН от БОД составил 54,5, в т. ч. от пневмоний -27,2 на 100 тыс. населения. Самые высокие ПСН от пневмоний в 2014 г. регистрировались в Дальневосточном федеральном округе (40,5 на 100 тыс.). В структуре смертности населения России по причине БОД в 2014 г. пневмония составляла 49,9 % всех случаев, хронические болезни нижних дыхательных путей -43,2 %, в т. ч. хроническая обструктивная болезнь легких -40,39 %, бронхиальная астма -2,3 %. За 9 мес. 2015 г. ПСН от БОД составил 52,9, от пневмоний -24,6, от гриппа и острых респираторных заболеваний -0,3 на 100 тыс. С пневмонией связано 46,5 % смертей от БОД. Ключевые слова: смертность населения, пневмония, грипп, профилактика.
Pneumonia is one of the most common respiratory diseases. The aim of this study was to analyze trends of pneumonia morbidity in adults > 18 years old and in children 0 – 14 years old in 2010 – 2014. Methods. Findings of Federal Statistic Surveillance of the Healthcare Ministry of Russian Federation were used to analyze pneumonia morbidity of adults and children living at different federal districts of Russian Federation in 2010 – 2014. Results. Respiratory diseases are the 2nd leading cause of morbidity in adults and the 1st leading cause of morbidity in children. The highest pneumonia morbidity in both groups was registered in 2010 that was 413.1 per 100,000 of age-adjusted population in adults and 986.1 per 100,000 of ageadjusted population in children. In 2014, the morbidity decreased to 338 cases in adults and 816 cases in children per 100,000 of age-adjusted population. In 2010, the highest pneumonia morbidity in adults and children was registered in the Central Federal District. In 2014, the highest pneumonia morbidity was registered in adult population of the Siberian Federal District and in children of the Far-Eastern Federal District. The overall pneumonia morbidity in Russia decreased in 2010 – 2014 excluding the Siberian Federal District, the Ural Federal District and the Volga Federal District. Conclusion. Average pneumonia morbidity in adults and children inRussia rise in 2010 due to A(H1N1)2009 influenza epidemics and then gradually decreased to 2014, probably due to the improved care and preventive measures.
Respiratory diseases (RD) represent one of the most urgent issues in Russian health care and have high socio-economic significance.The aim. To study the dynamics of total morbidity and mortality in the Russian Federation, as well as the mortality associated with RD in the working-age population in 2015 – 2019.Methods. The official statistical data of the Ministry of Health of the Russian Federation and the Federal State Statistics Service were analyzed.Results. In 2019, the total RD-associated morbidity increased by 5.4%, and the prevalence of pneumonia increased by 29.0% compared to 2015. In 5 federal districts (FD), the morbidity exceeded the average Russian morbidity in 2019 (40,694.7). The maximum level was observed in the North-Western FD (50,224.1). The prevalence of pneumonia (Russia – 524.4) in 4 FDs exceeded the average Russian prevalence. The maximum level was reported in the Far Eastern FD (749.2 cases per 100 thousand of the total population). The RD-associated mortality rate in Russia was 51.8 cases per 100 thousand in 2015 and 41.6 cases per 100 thousand in 2018 (–19.7%). In 2018, the highest RD-associated mortality was observed in the Siberian FD (68.0) and Far Eastern FD (57.8 per 100 thousand people). From January to December 2019, the highest mortality associated with pneumonia in the working-age population was observed in the Far Eastern FD (28.2 per 100 thousand people). The RD-associated mortality rate in the male population was 4.2 times higher than in the female population (26.7 and 6.3, respectively, per 100 thousand persons of matching age).Conclusion. The highest morbidity was found in 2018 and 2019 in the Northwestern FD and Far Eastern FD. The RD-associated mortality in the Siberian FD and Far Eastern FD exceeded the average Russian values. This last observation requires additional research to improve the quality of medical care.
According to the World Health Organization (WHO), bronchial asthma (BA) is a major non-communicable disease which affects both adults and children and thereby impacts the economy.The aim. To analyze the bronchial asthma morbidity and follow-up care in Russia in 2019 as compared with 2014.Methods. The official statistical data of the Ministry of Health of Russia and the Federal State Statistics Service (Rosstat) on BA was used. BA was defined as class X J45 – J46 (asthma, asthmatic status) according to the International Classification of Diseases and Health-Related Problems, the 10th revision of 1 989 (ICD-10).Results. The BA morbidity was 961.6 in 2014 and 1085.0 (+11.4%; p < 0,001) per 100 thousand of the total population in 2019 (1,592,596 people). BA accounted for 2.7% of all respiratory diseases (RD) morbidity. The BA morbidity in 2014 and 2019 were higher than average in 4 federal districts (FD) with the maximum rate in the Siberian FD (1,185.5 and 1,507.1 per 100 thousand of the total population, respectively). In 2019, the BA morbidity decreased among children aged 0 – 14 years, did not change among children aged 15 – 17 years and increased among the adults. In 2019, the highest rates among children aged 15 – 17 years were registered in the North-Western FD (2,943.7 per 100 thousand in the corresponding age group). 87.1% of BA patients received follow-up care. In 2019, 32.3% of all people with respiratory diseases (944.3 per 100 thousand of the total population) were under follow-up care. The highest number of BA patients under follow-up care was recorded in the Siberian FD (1,328.3 per 100 thousand of the total population), the lowest number – in the North Caucasian FD (288.3).Conclusion. There was an increase of BA morbidity from 2014 to 2019 with the highest numbers reported in the total population of Siberian FD and the lowest – in adolescents aged 15 – 17 years in North-Western FD. The quality of medical care correlated with high coverage with follow-up care.
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