[THE ORGANIZATIONAL RESERVES OF DECREASING ISCHEMIC HEART DISEASE MORTALITY IN THE RUSSIAN FEDERATION]

The article examines issue of identifying organizational reserves to reduce mortality of ischemic heart disease at the expense of optimization of management technologies under provision of medical care to patients with mentioned pathology. The national data from the statistical observation forms №№ 12, 14 and 30 and the "Monitoring of activities reducing mortality of ischemic heart disease" in 2016-2021 was analyzed. The co-integration of time series characterizing both mortality of ischemic heart disease and lethality of acute coronary syndrome were applied. The parameters of accessibility of medical care to patients with ischemic heart disease were analyzed. To evaluate power of impact of factors the elasticity coefficient was applied. It is established that mortality of ischemic heart disease decreased under increasing of number of both beds in Regional vascular centers (E=0.08%; R²=0.98) and primary vascular departments (E=0.31%; R²=0.98) and operations of coronary artery bypass (E=0.23%; R²=0.89). The lethality under acute coronary syndrome with ST segment elevation decreased at earlier hospitalization (E=0.5%; R²=0.97), thrombolysis (E=1.1%; R²=0.91) and per-cutaneous coronary intervention (E=1.5%; R²=0.60). The lethality at acute coronary syndrome without ST segment elevation decreased under increasing of percentage of per-cutaneous coronary intervention (E=1.7%; R²=0.72). The following reserves to decrease mortality were established: development of dispensary observation, expansion of network of vascular centers, increase of number of operations of coronary artery bypass, reduction of time of hospitalization, increase of cases of application of thrombolysis (especially at pre-admission stage) and application of per-cutaneous coronary intervention in case of acute coronary syndrome with with ST segment elevation.