[On the issue of Moscow health care reforms: a review of publications].

The article presents review of scientific publications from databases of CyberLeninka and RSCI related to Moscow health care reforms within the framework of the Moscow State program "The Development of Moscow health care (Metropolitan health care) for 2012-2020". The analysis established that during reforms positive shifts in Moscow health care system occurred, expressed by significant improvement in material and technical base of institutions, implementation of new diagnostic and treatment technologies, increasing of salary of medical workers, implementation of information technologies. However, the Moscow health care system continues to encounter challenges from problems related to staffing (especially the district service), high workload of medical personnel, insufficient level of motivation and low level of qualifications of medical workers. The implemented system of general medical practice did not contribute into strengthening the role of district physician as coordinator of patient flows. The fragmentation and lack of continuity in functioning of health care institutions remains too. The hospital-replacing technologies, designed to compensate reduction in beds, have not received development in primary health care. because of lacking of economic incentives for institutions and low tariffs. The serious problems associated with shortcomings in organization of functioning of medical institutions are established that requires further improvement of methods of analyzing functioning of medical institutions and organizational activities at all levels, considering effectiveness of activities implemented.

[The morbidity of population during implementation of Moscow health care reform].

The analysis of level and structure of general and primary morbidity according to medical care appealability of Moscow population during implementation of the State program "The Development of the City of Moscow Health Care (Metropolitan Health Care) in 2012-2020" was carried out according to the data from collections of main indices of functioning of medical organizations subordinated to the Moscow Health Care Department and health indices of Moscow population. The decreasing of both primary and general morbidity indices is established. At that, increasing of the life expectancy indices was marked. At the same time, population morbidity indices according to medical care appealability are not sufficiently reliable in assessing degree of achievement of results of any measures of improving population health due to their dependence on multitude of factors.

[The normative legal regulation of expertise of medical care quality in the Russian Federation].

In modern conditions, the support of quality of medical care is one of key issues in health care management. Therefore, quality control issues are most important ones. The effective tool for monitoring quality of medical care is the medical care quality expertise. Hence, the legal regulation of this type of activity acquires special relevance. The article considers absence of uniform approaches to medical care quality expertise that does not allow to apply comparative analysis to processes of medical care support in medical organizations of various affiliations and to monitor both medical care quality and prevalence of medical errors to implement strategy of ensuring medical care quality. The identified legal aspects determine the need for further improvement of normative legal regulation of medical care quality expertise, specifying its role in the system of quality control and safety of medical care, unification of corresponding approaches, regardless of type of financing of medical care, departmental or territorial affiliation.

[Euthanasia as a worldwide dilemma of modern times].

Nowadays, the most important place in medicine is occupied by ethical and legal aspects of organization of medical care and the provision of qualitative medical services to citizens. The main mechanism of functioning of the patient-centric health care system is implementation of the rights of patients as described in our country within the framework of international legal acts, the Constitution of the Russian Federation, the Civil, the Civil Procedure and Criminal Codes of the Russian Federation, as well as the Legislation on the protection of health of citizen. Since the mid of twentieth century, in many countries was widely discussed possibility of ensuring one of the most controversial and non-obvious rights of patient - the right to death. In medical practice, the mechanisms implementing this right are the acts of euthanasia, the assisted suicide, the voluntary death (refusal of water and food), "murder out of sympathy", terminal sedation and the phenomenon of "double effect" as well. The article presents review of scientific publications presented in national and international databases, highlighting prerequisites of implementation of euthanasia into practice and international experience of applying this mechanism of demise as well.

[The development of morbidity and mortality encoding in the system of the Ministry of Internal Affairs of Russia].

Despite attempts of improving actual system of morbidity and mortality accounting, the study research established significant real data distortion. These differences do not allow to assess in fullness complete picture of actual morbidity and mortality. Hence, improvement of approaches to increasing efficiency of indices data registration. The study was carried out in 2017-2019 on the bases of medical organizations of the Ministry of Internal Affairs of Russia. The study assessed quality of encoding of morbidity of 28 061 case histories/out-patient records. The size needed to obtain reliable results was determined using the Lopez-Jimenez formula. The statistical data was processed by MS Excel and Statistica-6 software. The most common errors were associated with non-rubricated and incorrectly rubricated diagnoses (53.2%, n = 2860). The second most common error in the structure of incorrectly formulated diagnosis was associated with using non-informative terms (14.6%, n = 785). The errors regarding non-observance of the ICD 10 revision requirements followed resulting in using and wordings not corresponding to modern classification (10.6%, n = 568). A number of errors was associated with unspecified localization of process (3.6%, n = 195) and other rarely occurring causes (2.6%, n = 139). The results of study permitted to conclude that one of the most promising directions of modernization of the encoding system is the automated encoding system.