Effectiveness of the Federal project “Fight against cardiovascular diseases” in the context of preventable causes of death in the Russian urban and rural settlements[Результативность Федерального Проекта «Борьба С Сердечно-Сосудистыми Заболеваниями» В Контексте Предотвратимых Причин В Городских И Сельских Поселениях России]

Introduction. In 2019, within the framework of the National project “Healthcare”, a Federal project “Fight against Cardiovascular Diseases” was launched to reduce mortality from heart attack, stroke and other vascular disorders by a quarter by 2024, predominantly among the Russian working population. For the health policy measures in the field of cardiovascular diseases to be successfully implemented, activities stipulated by the Federal project should be revised and updated and target indicators reassessed with due regard to the current situation. Another important managerial aspect is the overall project performance assessment in the context of the COVID-19 pandemic, which is associated with a significant increase in cardiovascular mortality. Material and methods. The Russian mortality among population aged 5-64 in 2003-2021 was analyzed identifying periods of rapid and slow mortality reduction (2005-2013, 2013-2019) as well as the pandemic period (2019-2021). Comparative analysis was conducted by gender, preventable and unavoidable death, urban and rural settlements. Results. Generally, dynamics in mortality from diseases of the circulatory system among population aged 5-64 is similar to the one in preventable mortality: the correlation coefficient in 1999-2021 equaled to 0.984 in males and 0.998 in females. From the beginning of the century and up to 2019, the contribution of male cardiovascular mortality to the total mortality hardly changed (37.3% in 2003 and 35.5% in 2019), while in females it decreased from 38.6% in 2003 to 29.3% in 2019. By 2021, it has decreased to 32.2% and 23.5%, respectively. Discussion. Improvements in quality of medical care can be evidenced by the decreased share of acute cardiovascular events in the structure of mortality from coronary heart disease. The use of the preventable mortality concept regarding diseases of the circulatory system makes it possible to evaluate effectiveness and develop practical recommendations for further mortality reduction, which fully corresponds to the entire process of increasing management efficiency. Conclusions. The study results show that the concept of preventable mortality is applicable to “Diseases of the circulatory system”; the technique allows for more in-depth analysis results regarding the impact of cardiovascular risk factors, which can serve as an evidence base to assess project performance in the field of fighting cardiovascular diseases. The use of this technique makes it possible to track improvements in diagnostic capabilities, access to and quality of medical care, despite the fact that the improved socio-economic well-being and preventive activities to reduce behavioral risk factors remain the main contributors to the decreased mortality from diseases of the circulatory system.