Network of Vascular Centers in the Russian as a way to reducing mortality in the working population

Abstract

Abstract Over the entire period of the state program aimed at reducing mortality from circulatory system diseases initiated in 2008 the number of Vascular Centers has increased from 85 to 140. According to the federal statistical observation form, the rate of Vascular Centers per 100 000 population increased 1.5 times from 0.066 to 0.095 in 2008 and 2017 respectively. As a result, the number of treated patients increased 6.3 times - from 53.1 to 327.3 per 100 000 population. During the analyzed period, the mortality rate of patients of Vascular Centers decreased from the average of 9.3% for all Vascular Centers in 2009 to 7.6% in 2017 (χ2 = 248.6, p < 0.0001) reflecting accumulation of experience of care delivery within the framework of the state program. The majority of patients with myocardial infarction and cerebrovascular diseases received treatment in the Vascular Centers. In 2017, 76.6% of all patients were admitted to Vascular Centers. From 2008 to 2017, the mortality from circulatory diseases in urban males of working age decreased by 36.1% (from 354.6 to 226.6 per 100 000 population), while cardiovascular mortality in rural males decreased to a greater extent - by 41.0% (from 394.2 to 232.0). Female mortality from circulatory system diseases (the level of which was initially five times lower) decreased to a lesser extent: from 67.0 to 44.5 per 100 000 urban females of working age (1.5 times - by 33.6%), and was even more pronounced in rural females - from 90.8 to 55.4 (by 39.0%). Therefore, along with the increase in the number of Vascular Centers the volume of specialized care including high-tech, increases while mortality decreases, reflected by the decreased mortality from myocardial infarction and other forms of acute ischemic heart disease. However, the activity of Vascular Centers did not affect the rate of mortality from cerebrovascular diseases in the Russian population. Key messages Through the activity of regional vascular centers since 2008 substantial reducing of patients’ mortality was registered from myocardial infarctions and other acute forms of ischaemic heart disease. Mortality from myocardial infarction has decreased in the last decade faster than in the period up to 2009.