Федерального Проекта Борьба С Сердечно-Сосудистыми Заболеваниями

Objectives

The federal project “Fight against Cardiovascular Diseases”, within the national project “Healthcare” and the Russian Federation healthcare-development state programme, was scheduled for implementation from 1 October 2018 to 31 December 2024. Its overarching aim was to reduce mortality from diseases of the circulatory system to 450 deaths per 100,000 population by 2024.[1][2]

• Reduce mortality from myocardial infarction from 40.0 per 100,000 population in 2017 to 30.6 in the target series, and mortality from acute cerebrovascular disorders from 92.9 to 71.1 per 100,000.[3]
• Reduce in-hospital mortality from myocardial infarction from 13.2% to 8.0%, and from acute cerebrovascular disorders from 19.1% to 14.0%.[3]
• Increase the share of percutaneous coronary interventions among patients with acute coronary syndrome from 36.0% to 60.0%, and raise their volume from 199,700 to 332,300 procedures.[3]
• Develop, approve and implement cardiovascular-disease programmes in all 85 constituent entities of the Russian Federation.[4][5]
• Strengthen primary prevention, early detection of disease and risk factors, secondary prevention, hypertension control, follow-up of adults, prevention of complications, and care quality in accordance with clinical recommendations and standards.[6][7][8][9]
• Improve emergency care, patient routing, high-technology treatment, rehabilitation, public awareness of symptoms of acute cerebrovascular and coronary syndromes, and staffing in primary and regional cardiovascular services.[6][10][11][12]
• Upgrade regional and primary cardiovascular-care infrastructure, including equipment for at least 140 regional vascular centres and at least 469 primary vascular departments during 2019–2024.[13][14][12][15]

Implementation

Delivery is structured through a federal project, a national cardiovascular-disease programme and regionally tailored programmes, supported by a Coordination Centre under the Ministry of Health of the Russian Federation and based in a subordinate federal institution. The Centre is intended to set requirements for regional programmes, provide methodological support and coordinate their implementation.[16][6][5][14]

• Establish a central dispatch service in each region; improve ambulance transport and routing for acute cerebrovascular and coronary syndromes; and provide public information on symptoms and appropriate action by patients and bystanders.[6][10][11][12]
• Expand specialised, high-technology and interventional care, including diagnostic, surgical, ventilation and early-rehabilitation equipment in regional vascular centres and primary vascular departments.[13][12][15][17]
• Develop and update clinical recommendations and standards through the Ministry of Health; support implementation through case reviews, demonstrative operations, virtual teaching, teleconferences, remote consultations and telemedicine.[9]
• Assess regional workforce needs annually by organisation, specialty and regional characteristics; use these assessments to inform training admissions, target training, distance learning, social support, continuing medical education and specialist accreditation.[18]
• Monitor regional-programme implementation through the Coordination Centre, produce annual reports with recommendations for adjustment, and prepare a final report on programme results and effectiveness by 2024.[5][12]
• Track headline outcomes and service indicators through baseline and annual regional trajectories, including circulatory-system mortality, myocardial-infarction mortality, acute cerebrovascular mortality, hospital mortality, intervention coverage and volume, and ambulance delivery to hospital.[2][3][19][20][21]
• Use indicator methodologies that identify calculation methods, baseline measures, data sources, responsible collection bodies, aggregation levels and reporting periods; cited sources include federal statistical forms No. 14 and No. 30 and population estimates from the Federal State Statistics Service.[22][23][24]
• Finance the federal project at a stated total of 75,222.40 million roubles for 2018–2024, including 74,682.40 million roubles for equipment provision and 540.00 million roubles for methodological support and coordination, allocated at 90.00 million roubles annually from 2019 to 2024.[25][26][27][28]

Federal-project oversight was assigned to a Deputy Prime Minister, project leadership to a Deputy Minister of Health, and administration to a department director.[1]The supplied material does not clearly specify a complete procurement model, enforcement mechanisms or sanctions for non-performance.[18][14]

Monitoring & Evaluation

The federal project on combating cardiovascular diseases uses a national and regional monitoring framework focused on reducing cardiovascular mortality, improving acute-care outcomes, expanding specialised interventions and strengthening preventive care through 2024.[2][3][29]

• Track mortality from diseases of the circulatory system, with a national target of 450 deaths per 100,000 population by 2024.[2]
• Monitor mortality from myocardial infarction and acute cerebrovascular disorders, hospital mortality, coverage and volume of percutaneous coronary interventions, ambulance delivery of patients with acute cerebrovascular disorders, and preventive medical examination coverage.[3][19][29][22][30]
• Apply indicator methodologies covering calculation methods, baseline measures, data sources, responsible data-collection bodies, aggregation levels and reporting periods.[22][23][31]
• Use state statistical forms No. 14 and No. 30 and population estimates as identified data sources for selected indicators; health authorities, including the Ministry of Health of the Chuvash Republic in the supplied extracts, are identified as data collectors.[23][32][24]
• Monitor regional programme implementation through a Coordination Centre under the Ministry of Health, prepare annual reports with recommendations for adjustment, and produce a final effectiveness report by 2024.[5][12]
• Track annual refurbishment or equipment targets for regional cardiovascular centres and primary cardiovascular-care departments, alongside annual workforce-needs assessments.[18][13][14]
• Use regionally disaggregated baseline values dated 31 December 2017 and annual target trajectories through 2024 for multiple indicators, although numerous extracted tables do not preserve a legible indicator title or methodology.[20][21][33][34]

Beyond assigned project roles, Coordination Centre reporting and indicator tables, the supplied extracts do not specify a comprehensive evaluation methodology, independent verification process, reporting format, enforcement mechanism or sanctions for underperformance.[35][36][23][37]

Costing & Financing

Financing is presented principally as planned federal-project expenditure for 2018–2024, largely through the federal budget, intergovernmental transfers and consolidated budgets of constituent entities of the Russian Federation. Several tables contain overlapping funding-source lines, so reported source categories should not be added together as separate expenditure totals.[38][27][28]

• Allocate 75,222.40 million roubles in total federal-project financing for 2018–2024, of which 74,682.40 million roubles is identified as intergovernmental transfers to regional budgets.[27][28]
• Allocate 74,682.40 million roubles for equipment provision in regional vascular centres and primary vascular departments, financed through the federal budget and consolidated regional budgets.[25][39]
• Allocate 540.00 million roubles for methodological support and coordination during 2018–2024, including 90.00 million roubles annually from 2019 to 2024.[26]
• Allocate 34,956.30 million Russian roubles from the federal budget during 2019–2021 to identify and equip at least 35 regional state cancer centres and 100 primary oncology departments.[40]
• Record zero financing in specified state extra-budgetary and other extra-budgetary funding lines, while several tables also show zero values for particular regional co-financing or transfer categories.[27][41][40][42]
• Present regional planned allocations across federal districts and constituent entities, including Central, North-Western, Siberian and Far Eastern federal districts and multiple individual regions.[43][44][45][46]

The extracts do not specify funding gaps, resource-mobilisation strategies, allocation formulae, affordability analysis, cost-effectiveness assumptions or broader economic assumptions.[38][47][48][49]