PUBLIC HEALTH MANAGEMENT
The Laboratory was established in 2019. The idea was supported by Academician-Secretary of the Department of Medical Sciences, the Russian Academy of Sciences (RAS), Acad. V.I. Starodubov and Scientific Supervisor of the Semashko National Research Institute of Public Health RAS, Acad. R.Yu. Khabriev. The Head is Dr. Dmitry O. Meshkov, MD, Dr. Sci. (Med.).
Dmitry O. Meshkov, Head of Laboratory No. 81
The Laboratory is based on two departments of the Semashko National Research Institute of Public Health RAS with their research areas, scientific infrastructure as well as national and international cooperation. The Laboratory continues research within the integrated concept of social hygiene and public health proposed by Acad. Yu.P. Lisitsyn. He was an outstanding Soviet and Russian scholar cofounding the science of social bases of healthcare. The Laboratory’s main task is to analyze and scientifically substantiate tools and methods for effective public health management based on interdisciplinary and interagency (intergovernmental) interaction under conflicting social and economic interests, considering modern technologies and mathematical methods for the analysis and information support of managerial decisions developed in the Institute.
Public health is one of the most important characteristics of society as a social organism: the aggregate of material and spiritual values cannot be created without it. This characteristic allows assessing the state of society on different levels: sociological (the potential of public health and social development described by various indices), socio-hygienic (population’s health determined by medical, statistical, and demographic indicators), and individual. A high level of public health ensures social well-being and stability as well as guarantees national security and economic development of the state.
The modern concept of public health management is based on a proactive risk‐based model. In this model, measures to ensure and improve public health aim at eliminating the risks of adverse events rather than correcting their consequences. Such public health management opportunities have appeared recently. They are associated with modern advances in information technology (particularly cloud technologies) for data management as well as innovative analysis and modeling methods.
Sergey N. Cherkasov
Public health forms under several factors: environmental conditions, lifestyle, heredity, and the healthcare system. These factors can be described by detailed social, economic, and environmental characteristics that indirectly determine the state of health (individuals or the population), the so-called health determinant. Proper consideration, monitoring, and forecasting of these indicators allow assessing current and prospective risks to public health, planning medical care needs, and utilizing healthcare resources rationally.
The second important element in proactive risk‐based public health management is the information block used to forecast and assess healthcare technologies at all stages (fundamental research, preclinical and clinical studies, systematic surveys and meta‐analysis, clinical guidelines, clinical‐economic analysis and modeling, complex Healthcare Technologies Assessment (HTA), situational modeling, and bioethical expertise). With this approach, the emergence of public health risks can be synchronized in time with the initiation and development of appropriate health technologies (chemical and biological medicines (particularly vaccines), medical devices, diagnosis tools, and information and management technologies).
The main areas of Laboratory’s work
- Proactive risk‐based healthcare management concept development;
- Rationale and development of evidence‐based tools for monitoring, planning, and forecasting of population’s health, risk factors, and determinants;
- Rationale and development of modern HTA and the rational use of medical technologies.
Within these works, note promising R & D activities in applied areas: creating cloud technologies to monitor and select the initial mortality cause based on the international classification of diseases (ICD‐10/11) of the World Health Organization (WHO) family of international classifications (WHO FIC); studying the relationship between social health determinants and the need for medical care for individual nosologies of noncommunicable diseases (cardiovascular and cancer diseases); analyzing the applicability and capabilities of modern mathematical methods and information technologies (artificial intelligence and self‐learning systems, Big Data, and decentralized databases (blockchain)) in healthcare.
Laboratory’s employees have been successfully cooperating with Russian research institutes and universities for a long time: the Semashko National Research Institute of Public Health RAS, the Russian Research Institute of Health (the Ministry of Health of the Russian Federation), Astrakhan State Medical University, Samara State Medical University, North‐Eastern Federal University, and St. Petersburg State University.
At the level of the Commonwealth of Independent States (CIS) and the Eurasian Economic Community, scientific cooperation takes place primarily within the Eurasian Cooperation on Clinical Guidelines and Development of National Health and the Expert Council on Healthcare under the Interparliamentary Assembly of the CIS Member States. The Institute is the only organization represented in this council by two members (chief researchers, Dr. S.N. Cherkasov, MD, Dr. Sci. (Med.), and Dr. D.O. Meshkov, MD, Dr. Sci. (Med.)).
At the international level, note the many years of fruitful cooperation with the WHO (the Headquarters in Geneva, Switzerland, and the Regional Office for Europe in Copenhagen, Denmark), the Clinical Research Initiative for Global Health (CRIGH), the Guidelines International Network (GIN), the European Clinical Research Infrastructure Network (ECRIN), the Piperska Group, and the Norwegian Institute of Public Health.
The Laboratory is the only one in Russia and the CIS countries as well as one of the few scientific structures in the world that provide a systematic approach to public health management. To maintain the scientific school and develop one of the most promising areas of the Institute’s work, Laboratory’s employees participate in the training of specialists at the local level (the Institute’s youth scientific school on methods for managing the need for medical care at the regional level using demographic, social, and economic determinants), the national level (joint seminars and educational courses with medical universities), and the international level (international complex measures).
Laboratory’s research results are internationally recognized as promising and unique. The interdisciplinary approach provides effective expert support for decisions in public health and healthcare management and, therefore, should be further developed. The corresponding practical tools based on modern mathematical and information technologies are in demand.