Introduction. Efficient use of bed capacity is a key element in improving the quality and accessibility of inpatient care. The “bed turnover” indicator reflects the intensity of bed utilization and is included among the indicators of national healthcare projects. The purpose is to analyze trends in the main performance indicators of 24-hour inpatient facilities in the Tyumen Region from 2013 to 2023 and to identify the determinants of changes in bed turnover. Materials and methods. A retrospective study was conducted using official statistical data from the Tyumen Region Department of Health and the Tyumen Regional Medical Information and Analytical Center (MIAC). Trends were assessed by absolute and relative changes; associations were examined using Spearman’s rank correlation (p<0.05). Results and conclusion. From 2013 to 2019, bed availability rate per 10 000 patients decreased from 66.1 to 59.3 (–10.29%), average length of stay declined from 10.11 to 9.84 days (–2.67%), and bed turnover increased from 33.1 to 34.0 (+2.72%). During the COVID-19 pandemic (2020–2021), average length of stay rose to 10.10 days and turnover fell to 33.3; by 2021 the turnover had recovered, rising up to 35.9. By the end of 2023, length of stay reached 8.8 days and bed turnover peaked at 38.4 patients. Correlation analysis revealed a strong negative association of bed turnover with both lengths of stay and bed availability and a positive association with bed occupancy and in-hospital mortality. Over the decade, the Tyumen Region increased bed utilization intensity: bed turnover rose by 16%, while average length of stay fell by 12%. The main drivers of these changes were reduced treatment durations and optimization of bed numbers.><0.05). Results and conclusion. From 2013 to 2019, bed availability rate per 10 000 patients decreased from 66.1 to 59.3 (–10.29%), average length of stay declined from 10.11 to 9.84 days (–2.67%), and bed turnover increased from 33.1 to 34.0 (+2.72%). During the COVID-19 pandemic (2020–2021), average length of stay rose to 10.10 days and turnover fell to 33.3; by 2021 the turnover had recovered, rising up to 35.9. By the end of 2023, length of stay reached 8.8 days and bed turnover peaked at 38.4 patients. Correlation analysis revealed a strong negative association of bed turnover with both lengths of stay and bed availability and a positive association with bed occupancy and in-hospital mortality. Over the decade, the Tyumen Region increased bed utilization intensity: bed turnover rose by 16%, while average length of stay fell by 12%. The main drivers of these changes were reduced treatment durations and optimization of bed numbers.

In the context of increasing demand for cross-border medical services, the special significance of the analysis of Russian regional exports continues to grow. The Tyumen region, which has a developed medical infrastructure, needs a systematic assessment of its competitive advantages for integration into the international market. Nosological analysis allows to identify the most demanded areas of medical care among foreign patients, which helps to optimize resources and form a targeted marketing policy of the region. Despite the active development of federal programs for the medical service export, most studies focus on all-Russian data, while regional specifics (including geographical, economic and clinical features) remain poorly studied. The objective is to study the medical service export of this Russian Federation region while taking into account the priority nosological groups, as well as to direct the study to assess the structure of the region's medical service export, highlighting the nosologies with the greatest export potential. Another objective is to determine the contribution of individual diseases to the regional medical service export based on the graphical data. The unified reporting format ensures comparability of data, which allows the methodology to be used as a standardized approach to analyzing the nosological structure of exports. The results of the study identify key priorities for the development of the export potential of medical services. The methodological advantage of the study is based on the use of a unified reporting system, which provides comparability of data between regions; allows the application of standardized analytical approaches; forms a unified methodological base for management decisions and can be replicated in other Russian regions participating in the implementation of the Federal project on the medical service export.

Background. The article shows the results of rating the psychosocial factors that are important for primary care physicians working at primary healthcare organizations in Moscow and the Moscow Oblast who decide to leave the profession. The research was conducted using the author's questionnaire. Purpose. To determine the significance of psychosocial factors to leave the profession among physicians. Materials and methods. The survey involved primary care physicians from city polyclinics in Moscow and the Moscow Oblast (n=400). The sociological, statistical, and analytical methods were used. Results. The study presents the ranking of psychosocial factors that cause physicians to leave the profession and indicates stress as the leading determinant.

Maintaining the professional stability of a specialist, which determines their efficiency in conditions of stress and high emotional and physical burden that are typical for nurses working at multidisciplinary urban medical organizations, is an urgent task. In the context of the modern healthcare system, where the burden on specialists is growing, studying professional sustainability is becoming particularly relevant. Purpose: to analyze the professional stability of nurses at multidisciplinary urban medical organizations. Materials and methods. The professional sustainability of 50 nurses working at a multidisciplinary urban medical organization was assessed using a sociological method — a questionnaire developed by the authors of this study, which is based on the Connor-Davidson sustainability scale (CD-RISC), the Maslach Professional Burnout questionnaire (MBI), and the ProQOL professional life quality scale. Using published data on methods of correcting professional stability, a workshop was scientifically justified, and its effectiveness was evaluated. Results. The majority of nurses showed insufficient levels of factors forming professional stability, such as stress tolerance, support, self-regulation, and job satisfaction, as well as high levels of emotional burnout. Based on the obtained data, a workshop was developed. The activities carried out among 50 nurses proved to be effective: after the seminar, the nurses significantly increased their awareness levels by 2 times, self-regulation skills by 2.2 times, emotional stability by 1.8 times due to stress levels decreasing by 1.9 times, and professional burnout by 2.2 times. Conclusion. The study revealed a low level of professional resilience among most nurses due to insufficient stress tolerance, self-regulation, peer support, and job satisfaction. A high level of emotional burnout exacerbates this situation. The workshop increased the nurses' awareness and improved self-observation and understanding of reactions. Regular mindfulness practices have reduced stress and emotional burnout and improved self-regulation skills and emotional resilience. This improved the response to stressful situations, confidence, and team support.

Introduction. Occupational stress leads health workers to somatic symptom disorders. Purpose. To identify somatic symptom disorders of healthcare workers. Methods and materials. The study involved a sample of 648 medical workers, who took part in the assessment on a voluntary basis. The authors used Apanasenko's method for assessing somatic health level and the Aleksandrovich symptomatic questionnaire modified by the V. M. Bekhterev National Research Medical Center for Psychiatry and Neurology, according to which somatic symptom disorders are part of the neurotic disorder. The Pearson correlation coefficient and the Chaddock scale were used for assessing and tracking somatic symptom disorders. Results. The following somatic symptom disorders among healthcare workers were identified: above-average level of allergic ailments, breathing difficulties, general discomfort in unpleasant situations, loss of appetite, sensation of blood rushing to the head, redness of the face, neck, chest, hunger attacks, tightness, excessive saliva accumulation, dry mouth, excessive thirst, lump in the throat and muscle tension; moderate level of heart pain, headache interfering with daily activities, dizziness, slight decrease in lung capacity, nervous sweating, sensitivity to noise, light or touch, increased systolic blood pressure, prolonged heart rate recovery time, somatization complaints, reduced grip strength, bodyweight gain, increased heart rate, rapid heartbeat with no activity, head rush, and tinnitus.

The most important biological components and pathological processes which underlie the formation and development of ASD have been established by modern scientific research today. However, psychological and pedagogical correction rather than medical examination and treatment prevails considerably when we claim the case management of such patients. The aim of the presented study is to analyze the dynamics of psychoneurological and laboratory indicators of ASD in the treatment of patients via biomedical technologies. Materials and methods. The study included 68 children with moderate and severe ASD. Such methods as pathopsychological, psychometric, clinical, laboratory and statistical ones were used. The results indicate a pro-inflammatory status of patients, heterogeneous changes in their metabolic status, endocrine dysfunction, all with various degree of compensation for impaired processes. Conducting personalized biomedical correction aimed at adjusting the disorders identified in the patient helps to reduce and diminish the severity of psychoneurological symptoms, normalize the somatic status, objectively confirmed by the standardization of the rated laboratory parameters during the treatment. Conclusion. Correction aimed at eliminating inner factors that support homeostasis disorders like inflammation, metabolic and hormonal dysfunctions contributes to the age- and gender-appropriate innate behavioral patterns formation, favours the normal physiological children development to become revealed and the so called “unpacking” process to spring up.