СМЕРТНОСТЬ ДЕТЕЙ ОТ ВРОЖДЕННЫХ ПОРОКОВ СЕРДЦА И ДОСТУПНОСТЬ ХИРУРГИЧЕСКОЙ ПОМОЩИ

Introduction. High efficiency of providing medical care to patients with congenital heart defects is based on a balanced assessment of the need for its volumes as well as on a dynamic assessment of the spent resources. Mortality reflects the productivity of the cardiovascular surgery. Objective: to compare mortality trends in children with congenital heart disease with the increase in the volume of surgical care. Material snd methods. Based on official data from 1989 to 2017, standardized mortality rates from congenital heart disease were calculated for age groups of children of both sexes (0-14, 0-1, 1-4, 5-14 years). For selected age groups, mortality dynamics were modelled. For Russian regions the average death rates were calculated for periods 1996-1998 and 2015-2017. Surgical activity was evaluated on the base of statistics which was collected by the A.N. Bakulev Center of Cardiovascular Surgery during 1995-2017. Results. Analysis of child mortality from congenital heart disease for the period from 1989 to 2017 showed that the uneven rate of the mortality decrease across different regions of the Russian Federation was rather due to insufficient disease detection because of low access to specialized health services and possible errors in death cause coding than geographical accessibility of health care facilities alone. Discussion. The beginning of the reduction in mortality from congenital heart disease coincided with the commissioning of the building of the V.I. Burakovsky Research Institute of Cardiosurgery. Conclusions. The identified reserves for reducing mortality substantiate the need to maintain (or increase in some cases) the level of financing of the Government Contract on “Cardiovascular Surgery”/“Congenital heart disease” section. Сrucial impact on reducing congenital heart disease mortality in Russia was made by increasing the availability of high-tech surgical care to the population.