[THE EVOLUTION OF PROACTIVE DISPENSARY MONITORING IN THE MOSCOW HEALTHCARE SYSTEM].

Economic and social losses due to epidemics of non-communicable diseases have put prevention and control of them on the first line in the field of sustainable development of the United Nations. The tasks of combating NCDs and risk factors within the framework of the Sustainable Development Goals require targeted actions on the part of States in the field of policy and legislation and provision of health systems with appropriate resources. In the Russian Federation, such work is being implemented within the framework of the national project "Healthcare", federal programs to combat oncological and cardiovascular diseases. Each subject takes into account the peculiarities of economic development, staffing, implementation of informatization processes, etc. The rapid pace of transformation of Moscow healthcare, its unique institutional structure allowed to form the basis for the effective development of a system of proactive dispensary monitoring of patients suffering from chronic diseases. The authors describe the process of formation of preventive work and organization of dynamic dispensary observation in Moscow. The paper presents in detail the organizational, administrative and technological resources used to create a unique system of dynamic dispensary observation. In addition, the article illustrates the personalized subsystem of dynamic dispensary observation in EMIAS and the institute of "physician assistant". The introduction of a proactive dispensary monitoring system will reduce premature mortality and disability among residents of the city. Moscow through an individual monitoring program and motivation for the responsible attitude of metropolitan patients to their health.

[Levilimab and baricitinib prescribing experience in outpatient COVID-19 patients' treatment].

AIM: To study the effect of levilimab or baricitinib in combination with standard therapy (ST) on the incidence of severe viral pneumonia associated with a new coronavirus infection COVID-19. MATERIALS AND METHODS: A multicenter, open-label observational study of the efficacy and safety of levilimab in combination with ST (group 1, n=100), baricitinib in combination with ST (group 2, n=139), or in comparison with ST (group 3, n=200) in outpatients with verified CT-1 pneumonia. RESULTS: According to the results of laboratory tests, patients treated with levilimab in combination with ST had the best dynamics of changes in CRP from reliably the highest level (mg/L) to the lowest in comparison with other groups. In the group of patients with ST, in contrast to the other groups, no dynamics of CRP was observed by day 5 of therapy. In group of hospitalized patients initially receiving levilimab in addition to ST, the rate of transfer to the intensive care unit (2 patients, 9.52%) and length of stay (4 days) was significantly lower compared to the values in patients in both the baricitinib group in combination with ST (7 patients, 15.56%; 5 days [interquartile range 36.5]) and in patients receiving ST alone (7 patients, 15.56%; 5 days [interquartile range 36.5]). Also in hospitalized patients we observed no statistically significant intergroup differences in the incidence of infectious complications and thromboembolic events, which confirms the safety of including levilimab or baricitinib in COVID-19 pathogenetic therapy regimens. Observational results support the hypothesis that the initial inclusion of levilimab or baricitinib in addition to ST is accompanied by a reduced risk of viral pneumonia progression. CONCLUSION: The addition of levilimab or baricitinib to the therapy regimen for coronavirus infection during the outpatient phase has demonstrated a preemptive anti-inflammatory effect and reduced the probability of lung tissue damage progression.

[THE ASSESSMENT OF THE RESEARCH POTENTIAL OF THE AMBULATORY-POLYCLINICAL INSTITUTIONS OF THE MOSCOW HEALTHCARE SYSTEM].

Scientific research and their inclusion in the health care system is an important part of modern medical science. To study the readiness of primary care physicians as well as administration staff to introduce a research component into the national health care system, "The Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department" conducted an online survey of two groups of respondents - physicians of primary care settings (n = 593) and heads of outpatient clinics in Moscow (n = 168) in 2021. The results of the study show the insufficient involvement of primary care doctors in research activities in their working places: more than half do not consider scientific activities as a priority, motivating it by the lack of conditions, practical skills, age and health status as well as high level of employment, although they do not reject it in the future. Heads of Moscow primary health care settings demonstrate similar answers. According to their opinion, research activities are poorly represented in organizations of this type, and most likely the situation will not be changed in the near future; about half do not have sufficient information about the number of employees engaged in scientific work and are rarely familiar with their topics (often extensive, represented by various fields of medicine); about one third of managers reported participating in research projects of Moscow City Department of Health. The study made it possible to identify barriers that prevent the introduction of research components into the activities of Moscow primary health care organizations, which should be taken into account when making managerial decisions.