[The diseases of digestive apparatus: the structure and dynamics at regional level].

The diseases of digestive apparatus significantly contribute into premature mortality of population. In the Republic of Buryatia, the diseases of digestive apparatus occupy third place in the structure of primary morbidity of population (6.7%) and fourth place in the structure of total mortality (6.6%). The purpose of the study is to establish characteristics of structure and dynamics of morbidity and mortality of population because of diseases of digestive apparatus in the Republic of Buryatia in 2009-2018. The analysis was based on data from state statistical reporting forms and official reports of the Territorial Authority of the Federal State Statistics Service in Republic of Buryatia for 2009-2018, reporting and accounting forms of medical organizations. The study was carried out using statistical, analytical methods, as well as elements of comparative analysis. The analysis testifies increasing of indicator of primary morbidity of diseases of digestive apparatus from 4051.0 to 4226.1 per 100 thousand of population and of mortality of diseases of digestive apparatus in the Republic of Buryatia from 60.6 to 62.5 per 100 thousand of population. The main causes of increasing of morbidity and mortality from diseases of digestive apparatus in the Republic of Buryatia are liver diseases, in particular liver fibrosis and cirrhosis because of alcoholization of population, undue diagnostics and treatment of liver pathology in the group "older than able-bodied age".

[The analysis of morbidity and mortality of population because of diseases of blood circulation system].

The article presents results of comparative analysis of morbidity and mortality of diseases of circulatory system in the Republic of Buryatia in 2003-2018. The population mortality depends on identification of risk factors for cardiovascular diseases, diseases of circulatory system and subsequent coverage of population with medical care, including dispensary monitoring. The analysis was based on data from State statistical reporting forms and official data of the Territorial Board of the Federal State Statistics Service in the Republic of Buryatia, including the form № 12 "The information on number of diseases registered in patients residing in area of medical organization servicing activity"; the form № 025-12/s "The Out-Patient Registration Card"; the form № 25-2/y "The Statistical Coupon for Final (updated) Diagnosis Registration". The study was carried out using statistical, analytical and comparative analysis methods. Currently, in the Republic of Buryatia, diseases of circular system occupying second place in the structure of total morbidity (15.7%) and primary disability of adult population (28.6%) are among leading cause of total population mortality (41.6%).

[The Regional Characteristics of Preventable Mortality of Population].

The concept of preventable mortality makes it possible to assess health care reserves and to identify priorities of their improvement at the regional level. It was established that in the Republic of Buryatia during 2005-2019, the percentage of the first group by the levels of prevention of causes of death of the old list (Preventable) decreased by 6.1%, mainly due to injuries, poisoning and other consequences of external factors. The percentage of the second and third groups increased by 4.4% and 1.7%, respectively. The cause of increasing of preventable mortality are malignant neoplasms and diseases of respiratory system. The increase of mortality from malignant neoplasms made from11.4% i.e. from 166.3 (2005) up to 185.3 (2019) per 100 thousand of population caused by increasing of mortality of malignant neoplasms included in the first group (malignant neoplasms of lip, mouth, pharynx, esophagus, liver, intrahepatic bile ducts, larynx, trachea, bronchi, lungs, urinary bladder). The increasing of mortality from malignant neoplasms in the second group occurred due to malignant neoplasms of skin, including melanoma, breast, cervix, uterus. In this case, the lateness of seeking medical care, which is characteristic of a large part of population is to be considered. The dynamics of proportion of respiratory diseases in the structure of the third group was characterized by wave-like curve, with minimum in 2008 (45.3%), and maximum in 2014 (65.1%). At the same time, overall mortality of respiratory diseases decreased from 84.9 to 54.6 per 100 thousand of population. Taking into account the results of the study, it is appropriate to update existing regional preventive programs with emphasis on improving diagnostic of malignant neoplasms and appropriateness of regular preventive examinations of population of the Republic.

[The social economical losses because of mortality due to alcohol-associated causes].

The evaluation of social economic losses based on the analysis of mortality of alcohol-associated causes in the Republic of Buryatia was carried out. It is established that in the Republic in 1993-2017 the average mortality due to alcohol-associated causes made up to 3.52% of total population mortality. This indicator is significantly higher among died individuals of able-bodied age, reaching 6.98±0.11% in this cohort. The economic damage due to direct alcohol-associated causes of death of individuals of able-bodied age made up to 4,123.9 million rubles, including 2038.3 million rubles in male population and 319.3 million rubles in female population, considering employment of analyzed population cohort. The social and economic damage due to population premature mortality in the Republic of Buryatia and directly related to alcohol consumption was calculated on the basis of potential demography principle. In average, the annual social losses made up to 80,248.37 man-years not survived till the end of able-bodied age. In total, the concomitant economic losses for the mentioned above period made up to 4.1 billion rubles. The obtained data testify both high level of alcoholization of population of the Republic of Buryatia and necessity of the activation of activities targeted to primary prevention.