RESUMEN
Over the past five years, development of telemedicine was accompanied by many changes. Despite the need for remote medical care, development of telemedicine technologies was not uniformly intensive, both in different countries and in regions of a single state (such as Russia). The purpose of the study is to evaluate dynamics of volume of medical care and number of types of services using telemedicine technologies in regions of the Russian Federation. The retrospective analysis was applied to data retrieved from the Form of the Federal Statistical Observation â 30 of 2019-2021, from documentation of territorial programs of state guarantees of free medical care of population and tariff agreements in regions of the Russian Federation in 2021-2022 and from the Federal Telemedicine System in 2021. The study established that total number of telemedicine consultations increased in 2021 by 23% as compared with 2020. The percentage of consultations financed by the Compulsory Health Insurance Fund also increased from 6.95% in 2020 to 11.72% in 2021. The number of patients being on remote monitoring increased in 2021 up to 44% as compared to 2020. In addition, percentage of patients receiving medical care through remote monitoring and financed by the Compulsory Medical Insurance Fund increased from 6.55% in 2021 to 19.96% as compared with 2020. In the territorial programs of state guarantees for seven regions of the Russian Federation the number of types of telemedicine services fixed in tariff agreements increased in 2022 as compared to 2021. However, it decreased in ten regions. The most common medical care profiles for which telemedicine consultations in the "physician-physician" format were provided by Federal medical organizations in 2021 were: oncology (55 regions of Russia requested consultations on this profile), pediatrics (45 regions), and intensive-care medicine (39 regions). The telemedicine solutions are in high demand, as it is demonstrated by increasing both of volume of remote medical care and of percentage of consultations financed by the Compulsory Medical Insurance Fund. The COVID-19 pandemic had rather strong impact on development of telemedicine. The alignment of market for telemedicine services in public health sector began in 2021 and it is confirmed by decreasing of total number of consultation types in tariff agreements in 2022. In terms of remote interaction in "physician-physician" format, situation continues to be stable. In the nearest future one should expect more gradual development of telemedicine in Russia with appearance of individual initiatives in terms of pilot projects and experimental law modes.