natszdravНациональное здравоохранениеNational Health Care (Russia)2713-069X2713-0703Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)10.47093/2713-069X.2023.4.4.5-13natszdrav-311Research ArticleМЕДИЦИНСКАЯ ДЕМОГРАФИЯMEDICAL DEMOGRAPHICSСтарение населения и устойчивость национальных систем здравоохранения. Обзор мировых практикPopulation ageing and national healthcare systems sustainability. A review of world practiceshttps://orcid.org/0000-0001-9612-8815КаневА. Ф.KanevA. F.

Канев Александр Федорович – ведущий аналитик отдела аналитики и мониторинга Координационного центра исследований и разработок в области медицинской науки, начальник отдела наукометрии и сопровождения публикаций

ул. Добролюбова, д. 11, г. Москва, 127254

Московский тракт, д. 2, г. Томск, 2634050

Aleksandr F. Kanev – Leading analyst, Analytics and monitoring Department, Coordination Center for research and development in medical science, Head of the scientometrics department

Dobrolyubova str., 11, Moscow, 127254

Moskovsky tract, 2, Tomsk, 2634050

kanev.af@ssmu.ruhttps://orcid.org/0000-0003-0098-1403КобяковаО. С.KobyakovaO. S.

Кобякова Ольга Сергеевна – д-р мед. наук, профессор, директор

ул. Добролюбова, д. 11, г. Москва, 127254

Olga S. Kobyakova – Dr. of Sci. (Medicine), Professor, Director

Dobrolyubova str., 11, Moscow, 127254

https://orcid.org/0000-0003-1896-6420КураковаН. Г.KurakovaN. G.

Куракова Наталия Глебовна – д-р биол. наук, заведующая отделом аналитики и мониторинга Координационного центра исследований и разработок в области медицинской науки

ул. Добролюбова, д. 11, г. Москва, 127254

Natalia G. Kurakova – Dr. of Sci. (Biological), Head of the Analytics and monitoring Department, Coordination Center for research and development in medical science

Dobrolyubova str., 11, Moscow, 127254

https://orcid.org/0000-0002-4255-6846ШибалковИ. П.ShibalkovI. P.

Шибалков Иван Петрович – канд. экон. наук, ведущий научный сотрудник отдела научных основ организации здравоохранения

ул. Добролюбова, д. 11, г. Москва, 127254

Ivan P. Shibalkov – Cand. of Sci. (Economical), Leading researcher, Department of scientific foundations of healthcare organization

Dobrolyubova str., 11, Moscow, 127254

ФГБУ «Центральный научно-исследовательский институт организации и информатизации здравоохранения» Министерства здравоохранения Российской Федерации; ФГБОУ ВО «Сибирский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal Research Institute for Health Organization and Informatics; Siberian State Medical UniversityRussian FederationФГБУ «Центральный научно-исследовательский институт организации и информатизации здравоохранения» Министерства здравоохранения Российской ФедерацииРоссияFederal Research Institute for Health Organization and InformaticsRussian Federation20230204202444513Copyright © Канев А.Ф., Кобякова О.С., Куракова Н.Г., Шибалков И.П., 20242024Канев А.Ф., Кобякова О.С., Куракова Н.Г., Шибалков И.П.Kanev A.F., Kobyakova O.S., Kurakova N.G., Shibalkov I.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.natszdrav.ru/jour/article/view/311

Ожидается, что к 2050 году доля людей старше 60 лет во всем мире будет составлять 22 %, а число лиц старше 80 лет к этому времени утроится, достигнув отметки в 426 миллионов. Старение населения ставит под угрозу устойчивое функционирование национальных систем здравоохранения, поскольку увеличение доли пожилого населения сопровождается ростом затрат на систему здравоохранения и снижением доступности медицинской помощи для остальных возрастных групп. На основании анализа и обобщения данных зарубежных публикаций о влиянии старения населения на устойчивость функционирования национальных систем здравоохранения систематизированы предлагаемые меры и модели оказания медицинской помощи, учитывающие изменение возрастной структуры населения. Анализ зарубежных публикаций позволил выделить следующие вызовы для системы здравоохранения, связанные со старением населения: рост затрат на оказание медицинской помощи, необходимость увеличения акцента на профилактические мероприятия, увеличение распространенности и тяжести хронических неинфекционных заболеваний и коморбидность, борьба с неравенством в отношении доступа к медицинской помощи, выраженным в территориальном (региональном), возрастном и гендерном аспектах, а также определяемым социально-экономическим статусом человека. Наиболее очевидным и реалистичным решением проблемы эксперты называют активную профилактику хронических заболеваний и более интенсивный контроль за состоянием здоровья со стороны населения. В качестве перспективных направлений ограничения расходов на здравоохранение указываются цифровые решения, обеспечивающие профилактику заболеваний и удаленный мониторинг за состоянием здоровья пожилого населения, основанные на использовании технологий машинного обучения, искусственного интеллекта и телемедицинских технологий

By 2050, the proportion of people over 60 years of age worldwide is expected to be 22 %, and the number of people over 80 is expected to triple by that time, reaching 426 million. Population aging threatens the sustainable functioning of national health care systems, since the increase in the proportion of the elderly population is accompanied by increased costs for the health care system and a decrease in the availability of medical care for other age groups. Based on the analysis and synthesis of data from foreign publications on the impact of population aging on the sustainability of the functioning of national healthcare systems, proposed measures and models of medical care that take into account changes in the age structure of the population are systematized. Analysis of foreign publications made it possible to identify the following challenges for the healthcare system associated with the aging population: rising costs of providing medical care, the need to increase emphasis on preventive measures, increasing prevalence and severity of chronic non-communicable diseases and comorbidity, inequality in access to medical care, expressed in territorial (regional), age and gender aspects, as well as determined by the socio-economic status of a person. Experts suggest that the most obvious and realistic solution to the problem is active prevention of chronic diseases and more intensive monitoring of the health status of the population. Digital solutions that provide disease prevention and remote monitoring of the health status of the elderly population, based on the use of machine learning technologies, artificial intelligence and telemedicine technologies, are identified as promising areas for limiting healthcare costs.

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The authors declare that there are no conflicts of interest present.