Medical Provision Research Articles

Study on the impact of smart city construction on the health of the elderly population--A quasi-natural experiment in China.

In the context of global aging, promoting the health of the elderly has become a critical issue. However, whether the development of smart cities can impact the health of older adults remains to be further validated. In this paper, based on panel data from the China Health and Retirement Longitudinal Study (CHARLS), a difference in difference model is used to empirically investigate whether smart city construction improves the health of older people in the region. The results show that smart city construction enhances the health of the elderly. Specifically, the construction achieved a significant improvement in the physical health of the elderly who did not live with their children. The health promotion effect of the smart city was more significant for the urban elderly than for the rural elderly. The elucidated mechanisms of influence suggest that smart cities bring about their effects through the promotion of urban leisure infrastructure, enhancement of medical service provision, advancement in urban environmental protection and stimulation of urban information and communication technology infrastructure development.

Long COVID awareness and receipt of medical care: a survey among populations at risk for disparities.

The COVID-19 pandemic has been characterized by disparities in disease burden and medical care provision. Whether these disparities extend to long COVID awareness and receipt of medical care is unknown. We aimed to characterize awareness of long COVID and receipt of medical care for long COVID symptoms among populations who experience disparities in the United States (US). We conducted a cross-sectional survey among a national sample of US adults between January 26-February 5, 2023. We surveyed approximately 2,800 adults drawn from the Ipsos probability-based KnowledgePanel® who identify as White, Black, or Hispanic, with over-sampling of Black, Hispanic, and Spanish-proficient adults. Awareness of long COVID was assessed with the question, "Have you heard of long COVID? This is also referred to as post-COVID, Long-haul COVID, Post-acute COVID-19, or Chronic COVID." Respondents reporting COVID-19 symptoms lasting longer than 1 month were classified as having long COVID and asked about receipt of medical care. Of the 2,828 respondents, the mean age was 50.4 years, 52.8% were female, 40.2% identified as Hispanic, 29.8% as Black, and 26.7% as White. 18% completed the survey in Spanish. Overall, 62.5% had heard of long COVID. On multivariate analysis, long COVID awareness was lower among respondents who identified as Black (OR 0.64; 95% CI 0.51, 0.81), Hispanic and completed the survey in English (OR 0.59; 95% CI 0.46, 0.76), and Hispanic and completed the survey in Spanish (OR 0.31, 95% C.I. 0.23, 0.41), compared to White respondents (overall p < 0.001). Long COVID awareness was also associated with educational attainment, higher income, having health insurance, prior history of COVID-19 infection, and COVID-19 vaccination. Among those reporting symptoms consistent with long COVID (n = 272), 26.8% received medical care. Older age, longer symptom duration and greater symptom impact were associated with receipt of medical care for long COVID symptoms. Of those who received care, most (77.8%) rated it as less than excellent on a 5-point scale. This survey reveals limited awareness of long COVID and marked disparities in awareness according to race, ethnicity, and language. Targeted public health campaigns are needed to raise awareness.

The relationship between the specialized hospitals and departments medical doctors provision with myocardial infraction and cerebral stroke lethality

The relationship between the specialized hospitals and departments medical doctors provision with myocardial infraction and cerebral stroke lethality

Survey on Stakeholder Cooperative Behavior for Designing Voluntary Medical Data Provision Motivation Mechanisms

The smooth provision of medical data is necessary to promote life science research utilizing artificial intelligence. However, data holders often do not voluntarily provide data. Previous literatures have stated several challenges of data sharing; however, studies on the perceptions of medical researchers are insufficient, especially in Japan. Aiming to explore data provision behavior in the actual Japanese context, we conducted a questionnaire survey on medical data use and data provision. The results clarified various obstacles to data sharing and revealed that whether the researcher is in an academic institution or a commercial company makes a difference.

Features of medical care provision in the profile «Maxillofacial surgery» in the Southern Federal District of the Russian Federation

To study the actual state of the organization of medical care for patients with the profile of «maxillofacial surgery» in the Southern Federal District of the Russian Federation in order to develop proposals for its optimization within the framework of a three-level system of medical care. We analyzed accounting and reporting materials characterizing the organization of medical care in the field of «Oral and maxillofacial surgery» to the population in the Southern Federal District of the Russian Federation. The population of the Southern Federal District of the Russian Federation is currently provided with accessible round-the-clock medical care in the field of maxillofacial surgery. The forces and means at the disposal of the district government allow this to be implemented. However, the article describes a number of obstacles to the provision of high-quality medical care in the field of maxillofacial surgery and suggests ways to eliminate them. Preparation of an Order defining the functioning of a three-level system of medical care for adults and children with maxillofacial pathology in the Southern Federal District of the Russian Federation, as well as more effective use of telemedicine consultations will significantly improve the availability and quality of medical care.

Home medical care and Home health care system and roles of the public health care in Korea

In the face of rapid aging in Korea, the demand for appropriate medical services for the elderly at home is increasing. This study investigates the current status of home medical care and Home health care in Korea based on the concept of Home-based primary care, and proposes strategies to implement home-care in public health centers and public hospitals that play a major role in the field of public health care.First of all, by presenting a conceptual framework for the current status of Korea’s home medical care and Home health care provision system, and described according to three financial resources: National Health Insurance(NHI), Long-Term Care Insurance(LTCI), and public health care. At the current level, the home health care systems are fragmented and they should be redesigned to improve the home care services.In order to implement home care in public health care institutions, a model centered on public health centers and public hospitals is proposed. Public health centers have various advantages, responsibility positions, and access to information, but they have working conditions and difficulties in providing incentives, and medical and nursing limitations. Public hospitals can provide a variety of services, but community access and insufficient knowledge are pointed out as disadvantages. Therefore, it is important to establish a cooperative system between the two institutions.Finally, we proposes the division and cooperation between public health centers and private medical institutions according to the level of service. Private medical institutions could be in charge of active treatment, medical services and skilled nursing cares. public health centers could perform monitoring and follow-up the patients. it is necessary to establish a coordinating system to cooperate the two parts of institutions.

How to Find Disruptions in Logistics Processes in the Cold Chain and Avoid Waste of Products?

This article presents a review of the literature related to the topic discussed and then discusses the system enabling the collection of data for analysis, the components of which are described in the paper. Next, a case study containing analyses of the circulation of logistic containers and the quality of deliveries is presented. Finally, a discussion of the results is presented. Background: This research is instrumental in navigating the intricacies of using these insulated containers of disturbances in the cold supply chain is imperative for ensuring the safety of perishable items, pharmaceuticals, and medical provisions, all of which necessitate precise temperature storage. Moreover, it holds significant sway over the efficacy of logistics, curtails losses, and guarantees adherence to regulatory stipulations and quality benchmarks. Research target: The research aimed to analyze the circulation of isothermal containers and indirectly assess the transportation quality for food products using the example of a 3PL company. Method: The article addresses issues encountered in the transportation of products within the cold supply chain. Using a company as an example, the temperature of coolboxes at the beginning of the logistics cycle, temperature distribution during transportation, and the temperature at the end of delivery were analyzed. The circulation of containers, their utilization over time, cycle durations, and the entire container circulation process were also examined. Results: Based on the collected data, recommendations were formulated to enhance product quality and increase container utilization. This research offers valuable insights into improving the efficiency and quality of logistics processes, specifically within the cold chain transportation industry, and provides recommendations for better managing temperature-sensitive product transportation.

Disease incidence and not case fatality drives the rural disadvantage in myocardial-infarction-related mortality in Germany

ObjectiveDemographic and infrastructural developments might compromise medical care provision in rural regions, particularly for acute health conditions. Studying the case of myocardial infarction (MI), we investigated how MI-related mortality at ages 65+ varies between rural and urban regions in Germany and to what extent differences are driven by varying case fatality and disease incidence. MethodsThe study relies on data containing all hospitalizations, cause-specific deaths and population counts for the total German population between years 2012–2018 and ages 65+. MI-related mortality, MI incidence and case fatality are compared between urban and rural regions in a population-wide analysis. The impacts of changing incidence and case fatality on rural-urban MI-related mortality differences are assessed using a counterfactual approach. ResultsRural regions in Germany show systematically higher MI-related death rates and MI incidence at ages 65+ compared to urban regions. Higher mortality is primarily the result of higher MI incidence in rural regions, while case fatality is largely similar. The rural excess in MI-related death rates would be nullified and 1 out of 6 MI-related deaths in rural regions could be prevented if rural regions in Germany would have at least the median MI incidence of urban regions. ConclusionsMI incidence and not case fatality drives the rural disadvantage in MI-related mortality in Germany. Higher MI incidence points towards potential regional variation in the effectiveness of disease prevention. The findings highlight that improving disease prevention at the patient level carries larger opportunities for reducing regional MI-related mortality inequalities in Germany.

EXPERT AND CLINICAL ASSESSMENT OF DEFICIENCIES IN PROVIDING CARE TO PATIENTS WITH TRAUMATIC BRAIN INJURY AND HEMORRHAGIC STROKE DUE TO THE RUPTURE OF CEREBRAL ANEURYSM

Introduction. The relevance of conducting this study is determined by the necessity to create organizational conditions and optimize the clinical-diagnostic aspect of medical care for patients with traumatic brain injury (TBI) and acute stroke. This aims to improve patients' quality of life by enhancing the effectiveness of medical care provision in Ukraine. This improvement is based on identifying the causes and analyzing deficiencies in medical care for these conditions.&#x0D; The aim of the research is to investigate the specificity of deficiencies in providing medical care to patients with isolated traumatic brain injury and acute hemorrhagic stroke due to the rupture of cerebral arterial aneurysms based on a retrospective analysis of medical documentation, as well as the results of patient treatment in cases of discrepancies between clinical and forensic diagnoses concerning the primary, concomitant diseases, and their complications.&#x0D; Materials and methods. Clinical assessment of the results of providing care to patients with traumatic brain injury and stroke was conducted through a retrospective analysis of medical documentation of patients who were hospitalized with these pathologies. The applied methods include clinical and laboratory investigations of homeostasis and metabolism parameters, and instrumental techniques.&#x0D; Results. In the identified influence of the timing of the operation (within the first few days) and the breakthrough of blood in the subarachnoid space of the brain, including with intracranial hemorrhage as a result of a re-rupture of a cerebral arterial aneurysm, on the risk of lethal outcomes of surgical treatment, a rationale for searching ways to optimize therapeutic tactics in this category of patients was provided. This includes identifying defects and shortcomings in the organizational aspect of medical care.&#x0D; Conclusions. Based on the analysis and identification of the most informative factors influencing the results of surgical treatment of cerebral aneurysms, a prediction system has been developed that allows calculating the probability of its outcome. The application of the forecast is advisable to consider in the prevention and timely detection of possible deficiencies in providing medical care to patients with stroke.

Tracheostomy-related durable medical equipment: Insurance coverage, gaps, and barriers

PurposeTracheostomy care is supply- and resource-intensive, and airway-related adverse events in community settings have high rates of readmission and mortality. Devices are often implicated in harm, but little is known about insurance coverage, gaps, and barriers to obtaining tracheostomy-related medically necessary durable medical equipment. We aimed to identify barriers patients may encounter in procuring tracheostomy-related durable medical equipment through insurance plan coverage. Materials and methodsTracheostomy-related durable medical equipment provisions were evaluated across insurers, extracting data via structured telephone interviews and web-based searches. Each insurance company was contacted four times and queried iteratively regarding the range of coverage and co-pay policies. Outcome measures include call duration, consistency of explanation of benefits, and the number of transfers and disconnects. We also identified six qualitative themes from patient interviews. ResultsTracheostomy-related durable medical equipment coverage was offered in some form by 98.1 % (53/54) of plans across 11 insurers studied. Co-pays or deductibles were required in 42.6 % (23/54). There was significant variability in out-of-pocket expenditures. Fixed co-pays ranged from $0–30, and floating co-pays ranged from 0 to 40 %. During phone interviews, mean call duration was 19 ± 10 min, with an average of 2 ± 1 transfers between agents. Repeated calls revealed high information variability (mean score 2.4 ± 1.5). Insurance sites proved challenging to navigate, scoring poorly on usability, literacy, and information quality. ConclusionsSeveral factors may limit access to potentially life-saving durable medical equipment for patients with tracheostomy. Barriers include out-of-pocket expenditures, lack of transparency on coverage, and low-quality information. Further research is necessary to evaluate patient outcomes.

Marketing activities of the all-Ukrainian pharmacy chain “Podorozhnyk” in Vinnytsia

Annotation. The health of the nation, medical and pharmaceutical provision at the current stage of the development of society is the most urgent problem. Ensuring the needs of the population in medical and pharmaceutical care in the conditions of a market economy is carried out through new forms of managerial activity of management and marketing. Pharmaceutical management is aimed at studying the pharmaceutical market and meeting the needs of the population in medicines and medical products. The purpose of the research is to study the “Podorozhnyk” pharmacy chain in Vinnytsia and the peculiarities of its marketing activities. A study of the organizational work of the “Podorozhnyk” pharmacy chain in Ukraine and the Vinnytsia region was conducted based on the materials of the Central Office and specific “Podorozhnyk” pharmacies. Methods used in the work: analytical, systemic approach, descriptive, comparative analysis. Research results: “Podorozhnyk” is an all Ukrainian pharmacy chain that is in constant development. The network has more than 1,500 pharmacies, more than 7,000 employees and more than 10 m. regular customers. 76 “Podorozhnyk” pharmacies have been opened and are operating in the Vinnytsia region, 32 of them in the city of Vinnytsia. New effective forms and methods of work are constantly being introduced in pharmacies. A pharmaceutical marketing service operates in the “Podorozhnyk” chain of pharmacies, the purpose of which is to study the demand for medical products and provide the population with high-quality, available medicines. The work of the “Podorozhnyk” chain of pharmacies is focused on the client – the consumer of pharmaceutical products and on a number of social projects (the help to the Armed Forces of Ukraine). An internet pharmacy courier delivery system for medicines has been created and is working. “Podorozhnyk” chain of pharmacies is a base for practical training of pharmaceutical personnel, starting with students of higher education institutions and working pharmacists.

Strategic management and risk control of emergency hospital construction: SWOT and STPA framework from a systems thinking perspective.

The construction of emergency hospitals is crucial for ensuring medical service provision during disasters. Assembled buildings have emerged as the preferred choice for large-scale emergency hospitals due to their rapid construction and high quality. However, the construction of emergency hospitals involves the collaboration of multiple departments, and there is a lack of research on the management of such construction projects. Given the urgent need for emergency hospitals, analyzing potential hazards in the construction process from a systemic perspective is essential to manage their construction effectively. In this study, the SWOT and STPA methods are employed to investigate the construction management of emergency buildings, with the Wuhan Vulcan Mountain Hospital in China serving as a case study for emergency management analysis. This study can provide ideas for emergency hospital management and a basis for controlling possible emergency construction accidents.

Emergency Medical Responses at US Immigration and Customs Enforcement Detention Centers in California

Knowledge of medical care in US Immigration and Customs Enforcement (ICE) detention centers is limited. Reviews show high rates of preventable deaths while in detention due to substandard medical care within detention centers. To describe characteristics of medical emergencies at ICE detention centers in California. This cross-sectional study analyzed emergency medical services (EMS)-reported medical emergencies activated through 911 from January 1, 2018, to December 31, 2022, at 3 of the 5 ICE detention centers in California: Adelanto ICE Processing Center, Imperial Regional Detention Facility, and Otay Mesa Detention Center. Medical services requiring 911 activation. Data included the number of EMS-reported medical emergencies; ICE-reported medical emergencies; patient age and sex; and medical data in the EMS report, including primary symptom, EMS provider (emergency medical technician or paramedic) impression, vital signs, and interventions performed, using descriptive statistics. In this analysis of 3 detention centers with a mean daily census of 775 (range, 504-1001) individuals per center, there was a median of 68 (IQR, 10-88) EMS-reported emergencies per center per year for a total of 1224 emergencies. The EMS-reported emergencies involved 881 males (72%) and 338 females (28%) with a median age of 39.0 (IQR 30.0-49.0) years. The ratios of female-to-male EMS-reported emergencies were 0.51 (95% CI, 0.31-0.87) at Adelanto, 0.86 (95% CI, 0.31-2.43) at Imperial, and 1.60 (95% CI, 1.40-1.83) at Otay Mesa. Pregnancy-related emergencies accounted for 12.4% (42 of 338) of emergencies in females. A total of 357 individuals (29.2%) had at least 1 abnormal vital sign during their EMS encounter. Psychiatric emergencies comprised 48 EMS responses (3.9%), despite higher rates of ICE-reported psychiatric-related complaints. The median number of monthly EMS-reported emergencies across all 3 centers was 3 (IQR, 0-9) vs 4 ICE-reported emergencies (IQR, 1-15). In this study of medical emergencies at 3 of 5 ICE detention facilities in California, there were discrepancies in EMS vs ICE reported emergencies. The data suggested that vulnerable populations, such as pregnant women, had an increased number of medical emergencies, while individuals with psychiatric emergencies accounted for fewer reported emergencies. Based on these findings, emergency medical care provision in ICE detention centers requires increased transparency to ensure appropriate delivery of care.

Medical, social and psychological needs analysis of the elderly in the conditions of military actions and their consequences

The analysis of a structured survey (questionnaire) of the elderly from the de-occupied territory shows a high level of need for long-term medical and social assistance, psychological, financial, and legal support and an insufficient degree of satisfaction or the complete absence of such assistance due to the war. A survey of the elderly from the de-occupied territory and a further analysis of the medical and social care provision state proved a high level of need for medical care, in all types of social services and insufficient availability or their complete availability. To overcome the existing problems, it is necessary to create organizational models of the complex long-term medical and social assistance state system for the elderly in the conditions of military actions and their consequences. _________________________________________________________________________________________ Keywords: elderly; hostilities conditions and their consequences; structured survey; comprehensive medical; social and psychological assistance

The present-day medical demographic situation in the Republic of Karelia

The analysis of basic medical and demographic indicators (primary morbidity and disability of adult population, mortality, age structure and life expectancy) and provision of medical care in the Republic of Karelia in 2011-2020 was carried out. It established consistently high level of primary morbidity of population with respiratory diseases; injuries, poisoning and other consequences of external causes; diseases of genitourinary system. Diseases of cardiovascular system and malignant neoplasms occupy leading positions in the structure of causes of disability and mortality of population during period under review. The levels of primary morbidity, disability and mortality of the Republic population are higher than at national level. The age structure of population has regressive type, there is long-term process of demographic aging, life expectancy is gradually increasing. Since 2011, the number of out-patient clinics increased up to 3 times and their capacity increased too. The degree of provision of population with medical personnel remained stable for a decade. The number of secondary medical personnel is decreasing, while both indicators are higher than the national indocators.

The application of telemedicine technologies under medical care provision to crew members on shipboard

The impact of development of technique and technology as result of scientific and technological progress in modern society tremendously affected population life of people in its various areas. One of these technologies is telemedicine. The telemedicine technologies permit to ensure accessibility of highly qualified medical care to travelers, ship crew members and persons located at remote objects. The actuality of application of telemedicine technologies is excessively high in conditions of providing medical care to ship crew members working hundreds miles away from nearest medical care station. The article considers application of telemedicine technologies in world-wide practice. The legal norms of applying telemedicine in the Russian Federation were analyzed. The results of scientific research of telemedicine application on shipboard are analyzed and both advantages and disadvantages of technology under study are determined. The ways of resolving existing problems are proposed to minimize risks associated with application of telemedicine technologies on shipboard.

Consumer Attitudes toward Community Elderly Services during Negative Population Growth and Sustainable Development

In 2022, it became apparent that China had officially become a nation witnessing negative population growth. Coinciding with the emergence of an aging society, the occurrence of population sustainable development has emerged as a crucial concern for society. In recent times, community-oriented elderly care has garnered prominence and materialized as a feasible pathway for confronting the matter of familial elderly care in a society with an aging populace. This study was conducted in three provincial capital cities in different regions of China. Based on the ABC theory and Maslow’s hierarchy of needs theory, and with reference to the research of relevant scholars, the study investigated consumers’ attitudes towards community elderly care services from the perspectives of health care services, housekeeping services, entertainment, catering services, etc., and put forward research hypotheses. The questionnaire was dimensionally reduced using factor analysis, and the hypotheses were tested using regression analysis. The findings validate that the delivery of medical provisions, domestic aid, recreational and culinary facilities, camaraderie, and counseling visits, along with bespoke services, substantially enhance consumer receptivity towards community-oriented elderly care provisions. As a result, these conclusions assume the role of valuable points of reference for entities engaged in furnishing such services.

Patient Admission and Mechanical Ventilator Allocation Decision-Making Processes by Frontline Medical Professionals in a Japanese ICU During the COVID-19 Pandemic: A Qualitative Study.

During the COVID-19 pandemic, the need to triage COVID-19 patients in ICUs emerged globally. Triage guidelines were established in many countries; however, the actual triage decision-making processes and decisions themselves made by frontline medical providers may not have exactly reflected those guidelines. Despite the need to understand decisions and processes in practice regarding patient ICU admission and mechanical ventilator usage to identify areas of improvement for medical care provision, such research is limited. This qualitative study was conducted to identify the decision-making processes regarding COVID-19 patient ICU admissions and mechanical ventilator allocation by frontline medical providers and issues associated with those processes in an ICU during the COVID-19 pandemic. Semi-structured, in-depth interviews were conducted with ICU physicians and nurses working at an urban tertiary referral hospital in Japan between February and April 2022. Patient characteristics that influenced triage decisions made by physicians and the interaction between physicians, nurses, and senior management staff upon making such decisions are discussed in this article. An implicated issue was the lack of legal support for Japanese physicians to practice withdrawal of life-sustaining treatments even during emergencies. Another issue was the impact of non-clinical forces-likely specific to health emergencies-on physicians' decisions regarding mechanical ventilator allocation, where such forces imposed a significant mental burden on the medical providers. We consider public policy and legal implications for future pandemics.

Regulatory and legal bases for the establishment and functioning of seafarers' health protection centers in the Russian Federation

Introduction. Ensuring the national interests of the Russian Federation in the World Ocean presupposes the development of medical and sanitary support for maritime activities, which currently requires integrated approaches in implementing the requirements for the preservation of the health of employees of the Russian fleet established by international legal acts on health and medical care in maritime navigation, of which the Russian Federation is a participant. In this regard, harmonization of legislation and improvement of measures related to the organization and functioning of seafarers' health protection centers are of particular importance.&#x0D; The study aims to conduct comprehensive legal monitoring of national regulatory and methodological documents regulating the activities of seafarers' health protection centers in comparison with international standards.&#x0D; Materials and methods. The authors have studied and analyzed scientific publications for the period from 1980 to 2023 defining the problems of medical and sanitary provision of water transport workers, methodological approaches of the World Health Organization, the International Labor Organization, the International Maritime Organization in this area, as well as current international and Russian regulatory legal acts, information from official websites of executive authorities and organizations.&#x0D; Results. The study found that today the system of seafarers' health protection, which previously existed in our country, has suffered significantly, and its restoration requires an integrated approach and centralization of medical support for maritime activities in accordance with the Maritime Doctrine of the Russian Federation and the Concept of Development of the Russian Federation Marine medicine. To this end, in the structure of organizations subordinate to the FMBA of Russia, in large port cities, head and regional centers for the protection of seafarers' health were established, carrying out accounting and analytical, organizational and methodological, regulatory, therapeutic and preventive, expert, scientific and educational activities. An important direction in the work of these centers is the implementation of preventive measures and the identification of occupational and work-related diseases. For the successful development of a unified system of medical and sanitary support for employees of the marine and river fleet, it is advisable to assign the functions of regulatory regulation in this area to the FMBA of Russia.&#x0D; Conclusion. The restoration of a full-fledged domestic system of providing medical care to water transport workers is possible through the creation and regulatory consolidation of the activities of seafarers' health protection centers in the structure of the FMBA organizations of Russia, which is an essential condition for achieving compliance of the national maritime policy with international requirements in the field of health and safety of navigation while maintaining its strategic goals and interests in the field of maritime and river navigation.&#x0D; Ethics. The study was conducted in compliance with Ethical standards. This study did not require the conclusion of the Ethics committee.

Thoracoscopy and Video-Assisted Thoracoscopy in Diagnostics of Pneumothoraxes, Traumatic Defeats of Thorax with Pneumothoraxes

In modern conditions, it is necessary to carry out interdisciplinary clinical and pharmacological, organizational and pharmaceutical researches on the correctness of diagnosis, treatment, pharmacotherapy and the appointment of life-necessary, effective, safe and high-quality medicines. This is due to the fact that the system of legal relations "doctor-patient-pharmacist" during the pandemic of COVID-19 and associated diseases (cardiovascular, oncological, tuberculosis, type I and II diabetes, asthma, HIV/AIDS, drug addiction, alcoholism, psychoneurological, injuries resulting from traffic accidents and combat operations, pain of various genesis and others) showed the need to improve the health care sector in each country, in general, and the work of a separate health care institution, doctor, nurse and pharmacist , in particular, that is, access to medical services and provision of medicines to patients.&#x0D; The analysis of the anonymous results of diagnostics among 1368 patients and in 160 victims with closed chest trauma was carried out. There were 425 patients with spontaneous pneumothorax. Thoracoscopy or video thoracoscopy was used to verify nosologies. During the thoracoscopic examination, bullous emphysema of the lungs was found among 336 patients (79%) with pneumothorax, tuberculosis was diagnosed among 47 people (11%), lung cancer in 6.8% – 29 people; silicosis – 2.4% (10 people); sarcoid – 0.7% (3 people). According to the results of histopathological examination of biopsies obtained during thoracoscopy, tuberculous exudative pleurisy was found in 563 patients, lung cancer was the cause of the exudate in 133 cases, pleural mesothelioma was diagnosed in 98 cases, exudative pleurisy was caused by a nonspecific inflammatory process of the lungs in 149 patients. Video-Assisted Thoracoscopy is recommended to be used in patients with closed chest trauma with multiple rib fractures, complicated by small hemothorax, pneumothorax, to diagnose possible damage to the diaphragm, lungs, and pericardium.