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Власов Василий Викторович

Факультет социальных наук

Профиль на hse.ru ↗ тел.: +7 (495) 772-95-90 | 2413
Публикаций
199
Языков
1
Наград
10
Конференций
4
Профиль Публикации (199) Курсы (10)

Профессиональные интересы

эпидемиологиядоказательная медицинаобщественное здоровьеБиомедицинская этика

Должности

  • Профессор — Факультет социальных наук, Департамент политики и управления, Кафедра управления и экономики здравоохранения

Био

  • · Начал работать в НИУ ВШЭ в 2009 году.
  • · Научно-педагогический стаж: 46 лет.

Образование

  • 1994 · Ученое звание: Профессор
  • 1993 · Доктор медицинских наук: специальность 14.01.04 «Внутренние болезни»
  • 1976 · Специалитет: Военно-медицинская академия им. С.М. Кирова, специальность «Лечебно-профилактическое дело», квалификация «Военный врач»

Опыт работы

  • · Профессор Сеченовского университета
  • · Ведущий научный сотрудник Центра профилактической медицины
  • · Профессор МФТИ
  • · Профессор Саратовского медицинского университета

Награды и поощрения

  • · Благодарность НИУ ВШЭ (март 2024)
  • · Благодарность факультета социальных наук НИУ ВШЭ (февраль 2024)
  • · Благодарность факультета социальных наук НИУ ВШЭ (январь 2023)
  • · Почетная грамота Высшей школы экономики (декабрь 2022)
  • · Благодарность Высшей школы экономики (сентябрь 2020)
  • · Почетный знак II степени Высшей школы экономики (июнь 2018)
  • · Надбавка за публикацию в журнале из Списка А (и приравненном к нему научном издании) (2025–2026, 2024–2025, 2023–2024)
  • · Надбавка за публикацию в международном рецензируемом научном издании (2022–2023, 2021–2022, 2020–2022, 2018–2020, 2017–2019)
  • · Надбавка за статью в зарубежном рецензируемом журнале (2015–2017)
  • · Лучший преподаватель — 2024–2025, 2017–2021, 2015

Конференции (4)

Показать все
  • · 2015: Съезд фтизиатров России (Воронеж). Доклад: Современная концепция доказательной медицины
  • · 2015: Лженаука в современном мире: медиасфера, высшее образование, школа (Санкт Петербург). Доклад: Лженаука на марше: на пути к гибели научных журналов
  • · 2014: Успехи и проблемы продвижения доказательной медицины (Москва). Доклад: Успехи и проблемы продвижения доказательной медицины в 2013 г.
  • · 2014: Этические и правовые аспекты нежелательных исходов медицинской помощи (Москва). Доклад: Этические и правовые аспекты нежелательных исходов медицинской помощи

Идентификаторы исследователя

Публикации (199)

Quantifying the fatal and non-fatal burden of disease associated with child growth failure, 2000–2023: a systematic analysis from the Global Burden of Disease Study 2023

2026 · ARTICLE · en

Background Child growth failure (CGF), which includes underweight, wasting, and stunting, is among the factors most strongly associated with mortality and morbidity in children younger than 5 years worldwide. Poor height and bodyweight gain arise from a variety of biological and sociodemographic factors and are associated with increased vulnerability to infectious diseases. We used data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 to estimate CGF prevalence, the risk of infectious diseases associated with CGF, and the disease mortality, morbidity, and overall burden associated with CGF. Methods In this analysis we estimated the all-cause and cause-specific (diarrhoea, lower respiratory tract infections, malaria, and measles) disability-adjusted life-years (DALYs) lost and mortality associated with stunting, wasting, underweight, and CGF in aggregate. We combined the burden associated with mild, moderate, and severe forms of CGF: stunting was defined as height-for-age Z scores (HAZ) less than –1, underweight was defined as weight-for-age Z scores (WAZ) less than –1, and wasting was defined as weight-for-height Z scores (WHZ) less than –1, according to WHO Child Growth Standards. Population-level continuous distributions of HAZ, WAZ, and WHZ were estimated for 2000 to 2023 using data from surveys, literature, and individual-level study data. The risk of incidence of, and mortality due to, diarrhoea, lower respiratory infections, malaria, and measles was separately estimated in a metaregression framework from longitudinal cohort data for Z scores less than –1. Finally, fatal outcomes associated with these diseases were estimated with vital registration, verbal autopsy, and case-fatality data, while non-fatal outcomes were estimated with surveys as well as health-care utilisation and case reporting data. The exposure prevalence and relative risk estimates were from continuous distributions, allowing for direct assessment of the attributable fractions for mild, moderate, and severe stunting, underweight, wasting, and the combined impact of child growth failure within populations. All estimates were age-specific, sex-specific, geography-specific, and year-specific. Findings We estimated that, in children younger than 5 years in 2023, CGF was associated with 79·4 million (95% uncertainty interval [UI] 47·0–106) DALYs lost and 880000 (517000–1 170000) deaths. This represented 17·9% (10·6–23·8) of 444 million (434–457) total under-5 DALYs and 18·8% (11·1–25·0) of all 4·67 million (4·59–4·75) under-5 deaths. Compared to stunting (33·0 million [24·1–42·2] DALYs, 373 000 [272 000–477000] deaths) and wasting (39·2 million [23·8–53·0] DALYs, 428 000 [256000–583000] deaths), childhood underweight was associated with the largest share of CGF-related disease burden: 52·2 million (21·9–75·1) DALYs and 573000 (236 000–824 000) deaths in children younger than 5 years in 2023. Interpretation CGF remains a leading factor associated with death and disability in children younger than 5 years, despite global attention and focused interventions to reduce the prevalence of associated CGF indicators. Our findings underscore the need for policies, strategies, and interventions that focus on all indicators of CGF to reduce its associated health burden.

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How the hybrid rules of free and paid medical care affect the post-socialist health system

2026 · ARTICLE · en

Background In some post-socialist countries, the rules of free and paid healthcare are not clear. We study Russia as an example to explore the combination of these rules and their role in the healthcare system. Methods We analyze the legislation defining the rules of free and paid healthcare; compare spending on free and paid services using statistical data; analyze the practices of free and paid healthcare using sociological surveys and in-depth interviews with the heads of state-owned and private clinics. Then we characterize the role the combination of rules plays in the healthcare system by sociological and statistical data. Results We found that in the combination of paid and free care in Russia, there is no clear distinction between the two principles of payment. Such a combination partially compensates for the insufficient resource provision and for its territorial differentiation. It improves consumer choice of care, supplements the finances of public providers, and increases their flexibility. The fuzzy distinction between paid and free care is used by the government as a means of mitigating the consequences of the underfunding of free care and avoiding the social tensions associated with it. This unclear distinction is not a failure, but a feature of the Russian healthcare system, which is hard to eliminate. Conclusions The hybrid system makes the healthcare provision more stable, but paid services reinforce inequality in access to medical care and inefficiency in resource utilization.

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Russian experience in healthcare quality assurance through standards of care: 2014–2023

2026 · ARTICLE · en

Objectives The Russian Federation inherited from the USSR a vast and poor healthcare system. Since 1996, the move to evidence-guided care has been initiated. The objective is to describe the last 10 years’ significant progress in the development of the centralised system of guidelines and quality assurance. Methods For the narrative review, we searched MEDLINE and the Central Medical Library, Moscow for reports relevant to the quality of healthcare and used our collections of the grey literature for the policy review. Neither patients nor the public were involved in the design and execution of this study. Results Legislation 2011 recognised clinical practice guidelines (CPGs) as an important tool in developing evidence-based practice. On top of the system are regulations of a new type—orders of medical care—which prescribe the patients’ track in the healthcare system, as well as the necessary staffing and equipment for participating organisations. CPGs describe the recommended interventions. Third, documents called ‘standards’ are derived from CPGs to calculate the average cost for costing diagnosis related groups and informing other payment decisions. At the same time, the Ministry of Health promotes the certification of medical organisations and introduces lean at the outpatient facilities. The criminal prosecution of physicians became more frequent, disturbing the profession. Conclusions A wide range of initiatives in quality assurance promise improvement in the quality of health care. Unfortunately, the insufficient and reduced funding, as well as solutions with unknown effectiveness, may limit prospects for improvement.

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Global, regional, and national burden of breast cancer among females, 1990–2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023

2026 · ARTICLE · en

Background Breast cancer is a leading cause of mortality and morbidity among females worldwide. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, we provided an updated comprehensive assessment of the epidemiological trends, disease burden, and risk factors associated with breast cancer globally, regionally, and nationally from 1990 to 2023. Methods Breast cancer incidence, mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) were estimated by age and sex for 204 countries and territories from 1990 to 2023. Mortality estimates were generated using GBD Cause of Death Ensemble models, leveraging data from population-based cancer registration systems, vital registration systems, and verbal autopsies. Mortality-to-incidence ratios were calculated to derive both mortality and incidence estimates. Prevalence was calculated by combining incidence and modelled survival estimates. YLLs were established by multiplying age-specific deaths with the GBD standard life expectancy at the age of death. YLDs were estimated by applying disability weights to prevalence estimates. The sum of YLLs and YLDs equalled the number of DALYs. Breast cancer burden attributable to seven risk factors was examined through the comparative risk assessment framework. The GBD forecasting framework was used to forecast breast cancer incidence and mortality from 2024 to 2050. Age-standardised rates were calculated for each metric using the GBD 2023 world standard population. Findings In 2023, there were an estimated 2·30 million (95% uncertainty interval [UI] 2·01 to 2·61) breast cancer incident cases, 764 000 deaths (672 000 to 854 000), and 24·1 million (21·3 to 27·5) DALYs among females globally. In the World Bank low-income group, where a low age-standardised incidence rate (ASIR) was estimated (44·2 per 100 000 person-years [31·2 to 58·4]), the age-standardised mortality rate (ASMR) was the highest (24·1 per 100 000 [16·8 to 31·9]). The highest ASIR was in the high-income group (75·7 per 100 000 [67·1 to 84·0]), and the lowest ASMR was in the upper-middle-income group (11·2 per 100 000 [10·2 to 12·3]). Between 1990 and 2023, the ASIR in the low-income group increased by 147·2% (38·1 to 271·7), compared with a 1·2% (–11·5 to 17·2) change in the high-income group. The ASMR decreased in the high-income group, changing by –29·9% (–33·6 to –25·9), but increased by 99·3% (12·5 to 202·9) in the low-income group. The increase in age-standardised DALY rates followed that of ASMRs. Risk factors such as dietary risks, tobacco use, and high fasting plasma glucose contributed to 28·3% (16·6 to 38·9) of breast cancer DALYs in 2023. The risk factors with a decrease in attributable DALYs between 1990 and 2023 were high alcohol use and tobacco. By 2050, the global incident cases of breast cancer among females were forecast to reach 3·56 million (2·29 to 4·83), with 1·37 million (0·841 to 2·02) deaths. Interpretation The stable incidence and declining mortality rates of female breast cancer in high-income nations reflect success in screening, diagnosis, and treatment. In contrast, the concurrent rise in incidence and mortality in other regions signals health system deficits. Without effective interventions, many countries will fall short of the WHO Global Breast Cancer Initiative's ambitious target of achieving an annual reduction of 2·5% in age-standardised mortality rates by 2040. The mounting breast cancer burden, disproportionately affecting some of the world's most vulnerable populations, will further exacerbate health inequalities across the globe without decisive immediate action.

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Организация и финансирование здравоохранения в России и в мире: тенденции и перспективы

2025 · BOOK · ru

Впервые в отечественной литературе представлена целостная картина развития здравоохранения в нашей стране и в мире в последние десятилетия. Книга содержит характеристики эволюции и состояния отрасли в России, включающие организацию оказания медицинской помощи, ее доступность для населения, систему финансирования, кадровое обеспечение. Они сравниваются с аналогичными характеристиками систем здравоохранения в других странах с развитой экономикой. Также впервые в отечественной практике проводится комплексный анализ актуального зарубежного опыта решения наиболее острых проблем организации и финансирования здравоохранения. Обсуждаются стоящие перед российским здравоохранением демографические, эпидемиологические, технологические, экономические и социальные вызовы и направления изменений в организации оказания медицинской помощи, финансировании, кадровом обеспечении отрасли, необходимые для адекватного ответа на эти вызовы и определяемые с учетом выявленных тенденций ее эволюции и мирового опыта.Книга является обобщением результатов многолетних исследований, выполненных в НИУ ВШЭ. Многие вопросы развития здравоохранения разрабатывались в этих исследованиях впервые в нашей стране: структурная трансформация системы здравоохранения, интеграция медицинской помощи, функциональный анализ системы финансирования отрасли, ее эволюция.Издание будет полезным для разных категорий читателей: организаторов здравоохранения, медицинских работников, исследователей и экспертов, студентов медицинских и экономических вузов, всех интересующихся проблемами здравоохранения.

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The impact of centralization on structural changes in healthcare: when it works

2025 · ARTICLE · en

Purpose: After a decade of post-Soviet decentralization of the healthcare in Russia the opposite trend has been dominating. This paper explores the impact of centralization of healthcare governance on the structure of the healthcare system in Russia, including shift in service delivery structure, the institutional organization of healthcare providers, and their interactions. Methodology: We employ quantitative and qualitative analysis to study how centralization has contributed to restructuring service delivery with instruments of utilization planning, vertical health programs, and centrally determined pathways of patients flows in a multi-level health care system. Findings: Centralization of healthcare governance has contributed to restructuring the Russian healthcare system, providing positive changes in structure of inpatient/outpatient care utilization, the organizational structure of service providers, and the structure of their activities. Inpatient care is increasingly replaced by outpatient care and day wards. Centralization contributed to creation of new types of medical organizations (perinatal centers, vascular centers, etc.), development of prevention, and strengthening of providers activity integration in a multi-level system of medical care. However, centralization has not been accompanied by the effective interaction of different levels of governance in developing structural reforms and their implementation in the regions. Uniform activities for the entire country do not take into account specific regional and local conditions. Some unified solutions are implemented in regions with negative consequences for the accessibility of care locally. The excessively centralized model of preventive measures does not provide an effective balance between detection of diseases and follow-up treatment. A so-called “new primary healthcare model”, initiated from the top, limits the development of alternative models that are needed in many regions of the country. The analysis concludes with a set of conditions that should be followed in designing and implementing a centralized model of healthcare governance.

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Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021

2025 · ARTICLE · en

Background Despite the well documented consequences of obesity during childhood and adolescence and future risks of excess body mass on non-communicable diseases in adulthood, coordinated global action on excess body mass in early life is still insufficient. Inconsistent measurement and reporting are a barrier to specific targets, resource allocation, and interventions. In this Article we report current estimates of overweight and obesity across childhood and adolescence, progress over time, and forecasts to inform specific actions. Methods Using established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021, we modelled overweight and obesity across childhood and adolescence from 1990 to 2021, and then forecasted to 2050. Primary data for our models included 1321 unique measured and self-reported anthropometric data sources from 180 countries and territories from survey microdata, reports, and published literature. These data were used to estimate age-standardised global, regional, and national overweight prevalence and obesity prevalence (separately) for children and young adolescents (aged 5–14 years, typically in school and cared for by child health services) and older adolescents (aged 15–24 years, increasingly out of school and cared for by adult services) by sex for 204 countries and territories from 1990 to 2021. Prevalence estimates from 1990 to 2021 were generated using spatiotemporal Gaussian process regression models, which leveraged temporal and spatial correlation in epidemiological trends to ensure comparability of results across time and geography. Prevalence forecasts from 2022 to 2050 were generated using a generalised ensemble modelling approach assuming continuation of current trends. For every age-sex-location population across time (1990–2050), we estimated obesity (vs overweight) predominance using the log ratio of obesity percentage to overweight percentage. Findings Between 1990 and 2021, the combined prevalence of overweight and obesity in children and adolescents doubled, and that of obesity alone tripled. By 2021, 93·1 million (95% uncertainty interval 89·6–96·6) individuals aged 5–14 years and 80·6 million (78·2–83·3) aged 15–24 years had obesity. At the super-region level in 2021, the prevalence of overweight and of obesity was highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and the greatest increase from 1990 to 2021 was seen in southeast Asia, east Asia, and Oceania (eg, Taiwan [province of China], Maldives, and China). By 2021, for females in both age groups, many countries in Australasia (eg, Australia) and in high-income North America (eg, Canada) had already transitioned to obesity predominance, as had males and females in a number of countries in north Africa and the Middle East (eg, United Arab Emirates and Qatar) and Oceania (eg, Cook Islands and American Samoa). From 2022 to 2050, global increases in overweight (not obesity) prevalence are forecasted to stabilise, yet the increase in the absolute proportion of the global population with obesity is forecasted to be greater than between 1990 and 2021, with substantial increases forecast between 2022 and 2030, which continue between 2031 and 2050. By 2050, super-region obesity prevalence is forecasted to remain highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and forecasted increases in obesity are still expected to be largest across southeast Asia, east Asia, and Oceania (eg, Timor-Leste and North Korea), but also in south Asia (eg, Nepal and Bangladesh). Compared with those aged 15–24 years, in most super-regions (except Latin America and the Caribbean and the high-income super-region) a greater proportion of those aged 5–14 years are forecasted to have obesity than overweight by 2050. Globally, 15·6% (12·7–17·2) of those aged 5–14 years are forecasted to have obesity by 2050 (186 million [141–221]), compared with 14·2% (11·4–15·7) of those aged 15–24 years (175 million [136–203]). We forecasted that by 2050, there will be more young males (aged 5–14 years) living with obesity (16·5% [13·3–18·3]) than overweight (12·9% [12·2–13·6]); while for females (aged 5–24 years) and older males (aged 15–24 years), overweight will remain more prevalent than obesity. At a regional level, the following populations are forecast to have transitioned to obesity (vs overweight) predominance before 2041–50: children and adolescents (males and females aged 5–24 years) in north Africa and the Middle East and Tropical Latin America; males aged 5–14 years in east Asia, central and southern sub-Saharan Africa, and central Latin America; females aged 5–14 years in Australasia; females aged 15–24 years in Australasia, high-income North America, and southern sub-Saharan Africa; and males aged 15–24 years in high-income North America. Interpretation Both overweight and obesity increased substantially in every world region between 1990 and 2021, suggesting that current approaches to curbing increases in overweight and obesity have failed a generation of children and adolescents. Beyond 2021, overweight during childhood and adolescence is forecast to stabilise due to further increases in the population who have obesity. Increases in obesity are expected to continue for all populations in all world regions. Because substantial change is forecasted to occur between 2022 and 2030, immediate actions are needed to address this public health crisis.

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Global, regional, and national prevalence of adult overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021

2025 · ARTICLE · en

Background Overweight and obesity is a global epidemic. Forecasting future trajectories of the epidemic is crucial for providing an evidence base for policy change. In this study, we examine the historical trends of the global, regional, and national prevalence of adult overweight and obesity from 1990 to 2021 and forecast the future trajectories to 2050. Methods Leveraging established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study, we estimated the prevalence of overweight and obesity among individuals aged 25 years and older by age and sex for 204 countries and territories from 1990 to 2050. Retrospective and current prevalence trends were derived based on both self-reported and measured anthropometric data extracted from 1350 unique sources, which include survey microdata and reports, as well as published literature. Specific adjustment was applied to correct for self-report bias. Spatiotemporal Gaussian process regression models were used to synthesise data, leveraging both spatial and temporal correlation in epidemiological trends, to optimise the comparability of results across time and geographies. To generate forecast estimates, we used forecasts of the Socio-demographic Index and temporal correlation patterns presented as annualised rate of change to inform future trajectories. We considered a reference scenario assuming the continuation of historical trends. Findings Rates of overweight and obesity increased at the global and regional levels, and in all nations, between 1990 and 2021. In 2021, an estimated 1·00 billion (95% uncertainty interval [UI] 0·989–1·01) adult males and 1·11 billion (1·10–1·12) adult females had overweight and obesity. China had the largest population of adults with overweight and obesity (402 million [397–407] individuals), followed by India (180 million [167–194]) and the USA (172 million [169–174]). The highest age-standardised prevalence of overweight and obesity was observed in countries in Oceania and north Africa and the Middle East, with many of these countries reporting prevalence of more than 80% in adults. Compared with 1990, the global prevalence of obesity had increased by 155·1% (149·8–160·3) in males and 104·9% (95% UI 100·9–108·8) in females. The most rapid rise in obesity prevalence was observed in the north Africa and the Middle East super-region, where age-standardised prevalence rates in males more than tripled and in females more than doubled. Assuming the continuation of historical trends, by 2050, we forecast that the total number of adults living with overweight and obesity will reach 3·80 billion (95% UI 3·39–4·04), over half of the likely global adult population at that time. While China, India, and the USA will continue to constitute a large proportion of the global population with overweight and obesity, the number in the sub-Saharan Africa super-region is forecasted to increase by 254·8% (234·4–269·5). In Nigeria specifically, the number of adults with overweight and obesity is forecasted to rise to 141 million (121–162) by 2050, making it the country with the fourth-largest population with overweight and obesity. Interpretation No country to date has successfully curbed the rising rates of adult overweight and obesity. Without immediate and effective intervention, overweight and obesity will continue to increase globally. Particularly in Asia and Africa, driven by growing populations, the number of individuals with overweight and obesity is forecast to rise substantially. These regions will face a considerable increase in obesity-related disease burden. Merely acknowledging obesity as a global health issue would be negligent on the part of global health and public health practitioners; more aggressive and targeted measures are required to address this crisis, as obesity is one of the foremost avertible risks to health now and in the future and poses an unparalleled threat of premature disease and death at local, national, and global levels.

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Characterising acute and chronic care needs: insights from the Global Burden of Disease Study 2019

2025 · ARTICLE · en

Chronic care manages long-term, progressive conditions, while acute care addresses short-term conditions. Chronic conditions increasingly strain health systems, which are often unprepared for these demands. This study examines the burden of conditions requiring acute versus chronic care, including sequelae. Conditions and sequelae from the Global Burden of Diseases Study 2019 were classified into acute or chronic care categories. Data were analysed by age, sex, and socio-demographic index, presenting total numbers and contributions to burden metrics such as Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLD), and Years of Life Lost (YLL). Approximately 68% of DALYs were attributed to chronic care, while 27% were due to acute care. Chronic care needs increased with age, representing 86% of YLDs and 71% of YLLs, and accounting for 93% of YLDs from sequelae. These findings highlight that chronic care needs far exceed acute care needs globally, necessitating health systems to adapt accordingly.

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Методические подходы к перспективному планированию кадрового обеспечения здравоохранения

2025 · PREPRINT · ru

Анализируются новые факторы, диктующие необходимость планирования кадров здравоохранения на среднесрочную и долгосрочную перспективу. Предложена концепция такого планирования с выделением модулей спроса и предложения кадров. Представлены параметры этих модулей, а также алгоритмы расчетов. Специальные разделы работы посвящены детализации планирования – по отдельным секторам здравоохранения, профессионально-квалификационным группам, врачебным специальностям, с учетом территориальной специфики формирования потребности в кадрах. Обосновываются допущения в отношении ожидаемых трендов эпидемиологических, технологических и организационных сдвигов, влияющих на кадровое обеспечение здравоохранения. Предложена оригинальная методика учета влияния отдельных факторов (расширения сети медицинских организаций, углубления диспансерного наблюдения, новых цифровых технологий и проч.) на потребность во врачебных кадрах, оказывающих медицинскую помощь в амбулаторных условиях. Предложены новые алгоритмы прогнозной оценки штатных нормативов. Результаты работы представляют интерес для исследователей социальной сферы и ее кадровых ресурсов, организаторов здравоохранения, специалистов по планированию

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Курсы (10)