Impact of Access to Specialized, Including High-Tech Medical Care for Patients With the Coronary Artery Disease on Coronary Artery Disease Mortality in the Russian Federation

Aim . To assess the effect of the availability of specialized, including high-tech, medical care for patients with ischemic heart disease (IHD) on mortality from IHD in the Russian Federation. Material and methods . To achieve the predetermined goal, we used cointegration of time series characterizing the mortality from IHD and the availability of specialized, including high-tech, medical care for patients with IHD in the Russian Federation for the period from 2015 to 2021: availability of cardiac beds; availability of cardiac surgery beds; availability of beds in regional vascular centers (RVC); availability of beds in primary vascular departments (PVD); availability of cardiologists in polyclinics; availability of cardiologists in hospitals; availability of cardiovascular surgeons (CVS) in hospitals; availability of interventional radiologists for endovascular diagnosis and treatment (EVDT) in hospitals; availability of therapeutic procedures of percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS); availability of elective PCI procedures; availability of coronary artery bypass grafting (CABG). Results . Cointegration tests showed a relationship between IHD mortality and the availability of beds at RVCs and PVDs and of CABG operations. Furthermore, an increase in the availability of RVC beds by 1 unit in each period results in a decrease in IHD mortality by 22.8 per 100,000 population during the year; an increase in the availability of PVD beds by 1 unit in each period results in a decrease in IHD mortality by 64.4 per 100,000 population during 2 years; and an increase in the availability of CABG by 1 unit in each period of time results in a decrease in IHD mortality by 34.8 per 100,000 population during 2 years. Conclusion . Thus, the most promising directions for concentrating healthcare resources to quickly reduce IHD mortality are the further deployment of a network of RVCs and PVDs, as well as increasing the number of CABG operations