<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">zdme</journal-id><journal-title-group><journal-title xml:lang="ru">Здоровье мегаполиса</journal-title><trans-title-group xml:lang="en"><trans-title>City Healthcare</trans-title></trans-title-group></journal-title-group><issn pub-type="epub">2713-2617</issn><publisher><publisher-name>ГБУ «НИИОЗММ ДЗМ»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.47619/2713-2617.zm.2026.v.7i1;114-123</article-id><article-id custom-type="elpub" pub-id-type="custom">zdme-366</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПУБЛИКАЦИИ НАЦИОНАЛЬНОГО НИИ ОБЩЕСТВЕННОГО ЗДОРОВЬЯ ИМ. Н.А. СЕМАШКО</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PUBLICATIONS OF N.A. SEMASHKO NATIONAL RESEARCH INSTITUTE OF PUBLIC HEALTH</subject></subj-group></article-categories><title-group><article-title>Типы оказания медицинской помощи в современной клинической практике московского стационара</article-title><trans-title-group xml:lang="en"><trans-title>Types of Medical Care in Modern Clinical Practice at a Moscow Hospital</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0008-8092-9202</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Аллау</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Allau</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Аллау Адель Али – аспирант</p><p>105064, г. Москва, ул. Воронцово Поле, д. 12</p></bio><bio xml:lang="en"><p>Adel A. Allau – Graduate Student</p><p>12, Vorontsovo Pole, 105064, Moscow</p></bio><email xlink:type="simple">Adel.allau@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Национальный научно-исследовательский институт общественного здоровья им. Н.А. Семашко</institution></aff><aff xml:lang="en"><institution>N.A. Semashko National Research Institute of Public Health</institution></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>03</day><month>04</month><year>2026</year></pub-date><volume>7</volume><issue>1</issue><fpage>114</fpage><lpage>123</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Аллау А.А., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Аллау А.А.</copyright-holder><copyright-holder xml:lang="en">Allau A.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.city-healthcare.com/jour/article/view/366">https://www.city-healthcare.com/jour/article/view/366</self-uri><abstract><p>В работе представлен анализ оказания медицинской помощи в стационарных медицинских учреждениях Москвы на примере хирургического отделения Научно-клинического центра № 3 Российского научного центра хирургии им. акад. Б.В. Петровского, на его основе предложена идентификация способов улучшения и развития организационных подходов к клинической практике в условиях стационара. Выделены типы оказания медицинской помощи в работе хирургических отделений, описаны отличительные особенности организации оказания хирургической помощи в Москве. Проанализированы итоги деятельности хирургического отделения НКЦ № 3 РНЦХ им. акад. Б.В. Петровского за 2021–2023 гг. Применительно к типам оказания медицинской помощи констатируются фундаментальные тенденции, такие как эволюция от преимущественно экстренной хирургии к сбалансированному портфелю плановых и неотложных вмешательств, дальнейшая технологическая модернизация с опережающим трендом перехода к малоинвазивным технологиям, формирование высокотехнологичного онкологического направления в работе хирургического отделения. Определены направления совершенствования оказания медицинской помощи в хирургическом отделении, включая внедрение расширенной системы индикаторов качества, развитие технологий формирования отдельных потоков для различных категорий пациентов, внедрение протоколов ускоренного восстановления и развитие хирургии одного дня. Исследуемый опыт может служить моделью для развития аналогичных подразделений, подтверждая возможность одновременного достижения высоких количественных показателей и поддержания приемлемого уровня качества медицинской помощи при условии системного подхода к организации хирургической службы.</p></abstract><trans-abstract xml:lang="en"><p>The paper presents an analysis of the types of medical care in inpatient medical institutions of Moscow using the example of the Department of Surgery of the Scientific and Clinical Center No. 3 of the Russian Scientific Center of Surgery named after Academician B.V. Petrovsky. Identification of the ways to improve and develop organizational approaches to clinical practice in Moscow hospitals has been elaborated on its basis. The types of medical care in the departments of surgery have been identified, and the distinctive features of the surgical care organization in Moscow have been described. The performance results of the Department of Surgery of the Scientific and Clinical Center No 3 of the Russian Scientific Center of Surgery named after Academician B.V. Petrovsky for 2021-2023 have been analyzed. Regarding the types of medical care, fundamental trends have been presented, including the transition from predominantly emergency surgery to balanced elective and emergency interventions; further technological modernization with an advanced trend of transition to minimally invasive technologies; and a focus on high-tech oncology in the department of surgery. The directions for improving the provision of various types of medical care in the clinical practice of the Department of Surgery have been identified, including the introduction of an expanded system of quality indicators, the development of technologies for patient flow split, the introduction of enhanced recovery protocols, and the development of same-day surgery. The experience of Scientific and Clinical Center No. 3 can serve as an example for similar departments, as it confirms the possibility of simultaneously achieving high quantitative indicators and maintaining the quality of medical care by implementing a systematic approach to surgical care.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>медицинская помощь</kwd><kwd>клиническая практика</kwd><kwd>хирургические отделения</kwd><kwd>стационары Москвы</kwd><kwd>типы хирургической помощи</kwd><kwd>цифровизация хирургии</kwd><kwd>высокотехнологичная хирургия</kwd><kwd>маршрутизация пациентов</kwd></kwd-group><kwd-group xml:lang="en"><kwd>medical care</kwd><kwd>clinical practice</kwd><kwd>department of surgery</kwd><kwd>Moscow hospitals</kwd><kwd>surgery types</kwd><kwd>surgery digitalization</kwd><kwd>high-tech surgery</kwd><kwd>patient routing</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">исследование проводилось без спонсорской поддержки.</funding-statement><funding-statement xml:lang="en">the authors received no financial support for the research.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Cartwright A. Human relations and hospital care. London: Routledge; 1964. https://doi.org/10.4324/9781003425151</mixed-citation><mixed-citation xml:lang="en">Cartwright A. Human Relations and Hospital Care. London. Routledge. 1964. https://doi.org/10.4324/9781003425151</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Ippoliti R., Falavigna G., Zanelli C. et al. Neural networks and hospital length of stay: an application to support healthcare management with national benchmarks and thresholds. Cost Effectiveness and Resource Allocation. 2021;19(1):67. https://doi.org/10.1186/s12962-021-00322-3</mixed-citation><mixed-citation xml:lang="en">Ippoliti R., Falavigna G., Zanelli C. et al. Neural Networks and Hospital Length of Stay: An Application to Support Healthcare Management with National Benchmarks and Thresholds. Cost Effectiveness and Resource Allocation. 2021;19:67. https://doi.org/10.1186/s12962-021-00322-3</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Qian M., Zhang X., Chen Y. et al. The pilot of a new patient classification-based payment system in China: the impact on costs, length of stay and quality. Social Science &amp; Medicine. 2021;289:114415. https://doi.org/10.1016/j.socscimed.2021.114415</mixed-citation><mixed-citation xml:lang="en">Qian M., Zhang X., Chen Y. et al. The Pilot of a New Patient Classification-Based Payment System in China: the Impact on Costs, Length of Stay and quality. Social Science &amp; Medicine. 2021;289:114415. https://doi.org/10.1016/j.socscimed.2021.114415</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Xu Y., Zheng X., Li Y. et al. Exploring patient medication adherence and data mining methods in clinical big data: A contemporary review. Journal of Evidence-Based Medicine. 2023;16(3):342-375. https://doi.org/10.1111/jebm.12548</mixed-citation><mixed-citation xml:lang="en">Xu Y., Zheng X., Li Y. et al. Exploring Patient Medication Adherence and Data Mining Methods in Clinical Big Data: A Contemporary Review. Journal of Evidence-Based Medicine. 2023;16(3):342-375. https://doi.org/10.1111/jebm.12548</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Гаджиева С.М. Создание центров компетенций (на примере организации центров амбулаторной онкологической помощи) в государственной системе здравоохранения: опыт Москвы. Национальное здравоохранение. 2024;5(3):30-40. https://doi.org/10.47093/2713-069X.2024.5.3.30-40</mixed-citation><mixed-citation xml:lang="en">Gadzhieva S.M. The Creation of Competence Centers (Using the Example of the Organization of Outpatient Cancer Care Centers) in the Public Health System: the Experience of Moscow. National Health Care (Russia). 2024;5(3):30-40. https://doi.org/10.47093/2713-069X.2024.5.3.30-40 (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Громов П.В. Трансформация бизнес-модели медицинского учреждения с целью повышения клиентоцентричности в сфере производственной медицины. Вестник Юридического института МИИТ. 2024;1(45):57-72.</mixed-citation><mixed-citation xml:lang="en">Gromov P.V. Transformation of the Business Model of a Medical Institution to Increase Customer-Centered Orientation in the field of Industrial Medicine. Bulletin of the Law Institute of MIIT. 2024;1(45):57- 72. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Al Harbi S., Aljohani B., Elmasry L. et al. Streamlining patient flow and enhancing operational efficiency through case management implementation. BMJ Open Quality. 2024;13(1):e002484. https://doi.org/10.1136/bmjoq-2023-002484</mixed-citation><mixed-citation xml:lang="en">Al Harbi S., Aljohani B., Elmasry L. et al. Streamlining Patient Flow and Enhancing Operational Efficiency through Case Management Implementation. BMJ Open Quality. 2024;13:e002484. https://doi.org/10.1136/bmjoq-2023-002484</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Mihalj M., Corona A., Andereggen L. et al. Managing bottlenecks in the perioperative setting: optimizing patient care and reducing costs. Best Practice &amp; Research Clinical Anaesthesiology. 2022;36(2):299-310. https://doi.org/10.1016/j.bpa.2022.05.005</mixed-citation><mixed-citation xml:lang="en">Mihalj M., Corona A., Andereggen L. et al. Managing Bottlenecks in the Perioperative Setting: Optimizing Patient Care and Reducing Costs. Best Practice &amp; Research Clinical Anaesthesiology. 2022;36(2):299-310. https://doi.org/10.1016/j.bpa.2022.05.005</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Naderi B., Roshanaei V., Begen M.A. et al. Increased surgical capacity without additional resources: Generalized operating room planning and scheduling. Production and Operations Management. 2021;30(8):2608- 2635. https://doi.org/10.1111/poms.13397</mixed-citation><mixed-citation xml:lang="en">Naderi B., Roshanaei V., Begen M.A. et al. Increased Surgical Capacity without Additional Resources: Generalized Operating Room Planning and Scheduling. Production and Operations Management. 2021;30(8):2608-2635. https://doi.org/10.1111/poms.13397</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Вошев Д.В., Вошева Н.А., Сон И.М., Драпкина О.М. Факторы, оказывающие влияние на цифровую трансформацию в первичной медико-санитарной помощи (обзорная статья). Современные проблемы здравоохранения и медицинской статистики. 2023;(4):751-774. https://doi.org/10.24412/2312-2935-2023-4-751-774</mixed-citation><mixed-citation xml:lang="en">Voshev D.V., Vosheva N.A., Son I.M., Drapkina O.M. Factors Influencing the Digital Transformation in Primary Health Care (Review Article). Current Problems of Health Care and Medical Statistics. 2023;4:751- 774. https://doi.org/10.24412/2312-2935-2023-4-751-774 (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Есина Е.А., Калицкая В.В., Борзунов И.В. и др. Цифровые технологии как драйвер трансформации экономического развития здравоохранения. Естественно-гуманитарные исследования. 2024;(4):122-125.</mixed-citation><mixed-citation xml:lang="en">Esina E.A., Kalitskaya V.V., Borzunov I.V. et al. Digital Technologies as a Driver for Transformation of Economic Development of Healthcare. Natural Sciences and Humanities Research. 2024;4(54):122-125. (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Коробейникова А.Н. Система поддержки принятия врачебных решений: от общего к частному. Инновационное развитие врача. 2023;(3):51-58. https://doi.org/10.24412/cl-37091-2023-3-51-58</mixed-citation><mixed-citation xml:lang="en">Korobeynikova A.N. Medical Decision Support System: from General to Specific. Innovative doctor’s development. 2023;3:51-58. https://doi.org/10.24412/cl-37091-2023-3-51-58</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Gracia Martínez J.L., Pfang B., Morales Coca M.Á. et al. Implementing a closed loop clinical decision support system for sustainable preoperative care. npj Digital Medicine. 2025;8(1):6. https://doi.org/10.1038/s41746-024-01371-7</mixed-citation><mixed-citation xml:lang="en">Gracia Martínez J.L., Pfang B., Morales Coca M.Á. et al. Implementing a Closed Loop Clinical Decision Support System for Sustainable Preoperative Care. npj Digital Medicine. 2025;8(1):6. https://doi.org/10.1038/s41746-024-01371-7</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Федоткина С.А., Ахминеева А.Х., Карайланов М.Г. Лучшие практики применения телемедицинских технологий в Российской Федерации и за рубежом. Siberian Journal of Life Sciences and Agriculture. 2023;15(3):295-312. https://doi.org/10.12731/2658-6649-2023-15-3-295-312</mixed-citation><mixed-citation xml:lang="en">Fedotkina S.A., Akhmineyeva A.Kh., Karaylanov M.G. Best Practices for the Application of Telemedical Technologies in the Russian Federation and Abroad. Siberian Journal of Life Sciences and Agriculture. 2023;15(3):295-312. https://doi.org/10.12731/2658-6649-2023-15-3-295-312 (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Von Schudnat C., Schoeneberg K.P., Albors-Garrigos J. et al. The economic impact of standardization and digitalization in the operating room: A systematic literature review. Journal of Medical Systems. 2023;47(1):55. https://doi.org/10.1007/s10916-023-01945-0</mixed-citation><mixed-citation xml:lang="en">Von Schudnat C., Schoeneberg K.P., Albors-Garrigos J. et al. The Economic Impact of Standardization and Digitalization in the Operating Room: A Systematic Literature Review. Journal of Medical Systems. 2023;47(1):55. https://doi.org/10.1007/s10916-023-01945-0</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Munshi C., Garai R., Mondal S. et al. Fundamentals of the global healthcare system and its reforms during the COVID-19 pandemic. Global Health Economics and Sustainability. 2025;3(3):74-91. https://doi.org/10.36922/ghes.8492</mixed-citation><mixed-citation xml:lang="en">Munshi C., Garai R., Mondal S. et al. Fundamentals of the Global Healthcare System and Its Reforms During the COVID-19 Pandemic. Global Health Economics and Sustainability. 2025;3(3):74-91. https://doi.org/10.36922/ghes.8492</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Saulnier D.D., Duchenko A., Ottilie-Kovelman S. et al. Re-evaluating our knowledge of health system resilience during COVID-19: lessons from the first two years of the pandemic. International Journal of Health Policy and Management. 2022;12:6659. https://doi.org/10.34172/ijhpm.2022.6659</mixed-citation><mixed-citation xml:lang="en">Saulnier D.D., Duchenko A., Ottilie-Kovelman S. et al. Re-Evaluating Our Knowledge of Health System Resilience During COVID-19: Lessons from the First Two Years of the Pandemic. International Journal of Health Policy and Management. 2023;12(1):1-18. https://doi.org/10.34172/ijhpm.2022.6659</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Troisi R., De Simone S., Vargas M., Franco M. The other side of the crisis: organizational flexibility in balancing Covid-19 and non-Covid-19 health-care services. BMC Health Services Research. 2022;22(1):1096. https://doi.org/10.1186/s12913-022-08486-1</mixed-citation><mixed-citation xml:lang="en">Troisi R., De Simone S., Vargas M., Franco M. The Other Side of the Crisis: Organizational Flexibility in Balancing Covid-19 and non-Covid-19 Health-Care Services. BMC Health Services Research. 2022;22(1):1096. https://doi.org/10.1186/s12913-022-08486-1</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Полушин Ю.С. Сепсис и менеджмент: как улучшить исходы лечения больных сепсисом. Вестник хирургии имени И.И. Грекова. 2022;181(5):38-46. https://doi.org/10.24884/0042-4625-2022-181-5-38-46</mixed-citation><mixed-citation xml:lang="en">Polushin Yu.S. Sepsis and Management: How to Improve Treatment Outcomes for Patients with Sepsis. Grekov’s Bulletin of Surgery. 2022;181(5):38-46. https://doi.org/10.24884/0042-4625-2022-181-5-38-46 (In Russ.)</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Bhati D., Deogade M.S., Kanyal D. Improving patient outcomes through effective hospital administration: a comprehensive review. Cureus. 2023;15(10):e47731. https://doi.org/10.7759/cureus.47731</mixed-citation><mixed-citation xml:lang="en">Bhati D., Deogade M.S., Kanyal D. Improving Patient Outcomes Through Effective Hospital Administration: A Comprehensive Review. Cureus. 2023;15(10):e47731. https://doi.org/10.7759/cureus.47731</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Connor L., Dean J., McNett M. et al. Evidence-based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review. Worldviews on Evidence-Based Nursing. 2023;20(1):6-15. https://doi.org/10.1111/wvn.12621</mixed-citation><mixed-citation xml:lang="en">Connor L., Dean J., McNett M. et al. Evidence-Based Practice Improves Patient Outcomes and Healthcare System Return on Investment: Findings from a Scoping Review. Worldviews on Evidence-Based Nursing. 2023;20(1):6-15. https://doi.org/10.1111/wvn.12621</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
