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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)

May the Cleaning of Prescriptive Documents Using Best Evidence Reduce the Cost of Prescribed Healthcare?

2021 · ARTICLE · en

Objectives Clinical practice is developing under influence of the evidence-based clinical practice guidelines (EBCPG). In Russia development of the documents prescribing the content of care is connected with the idea that they may be used as well for estimation of the cost of care. The outcome is the national healthcare legislation of 2011. It dictates that care should be planned, funded, provided, and evaluated in agreement with standards of healthcare (SHC)—documents prescribing the content of care. The objective of this study was to evaluate how the correction of the SHC with the relevant EBCPG may change the cost of the prescribed care. Methods We selected the random sample of the SHC from the approved by the Ministry of Health for primary healthcare (SPHC) and specialized healthcare (SSHC). We analyzed interventions comparing SHC to the relevant EBCPG. Not recommended interventions were considered unnecessary. If the recommended by EBCPG intervention was missed in the SHC, then it increased the cost. We take the drug costs and the costs of interventions from the relevant ministerial registries. We calculated the total cost of the SHC by summing up the cost of each medical intervention/medications specified in the SHC. Results SPHC and SSHC both contain medical interventions and drugs that should not be provided. The total cost of all SHC included became lower: SPHC cost decreased by 66%, SSHC by 19%. The smaller change of the cost of SSHC is explained by the fact that the major part of the total cost of SSHC is the stay in a hospital. Conclusion Correction of the SHC using EBCPG may reduce the cost of care

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Результаты применения кт-ангиографии брахиоцефальных артерий у пациентов с ОНМК по ишемическому типу и их связь с тяжестью неврологической симптоматики по шкале NIHSS

2021 · ARTICLE · ru

Определить выявляемость тромбоза крупных брахиоцефальных артерий при КТ-ангиографии (КТА) у пациентов с острым нарушением мозгового кровообращения (ОНМК) по ишемическому типу, в зависимости от тяжести неврологической симптоматики по международной шкале NIHSS. Материалы и методы. В исследование вошли 173 пациента (100%), госпитализированные в Городскую клиническую больницу им. М.П. Кончаловского г. Москвы в течении 2019 года, которым была выполнена КТА экстра- и интракраниальных артерий: 94 женщины (54,3%), мужчин 79 (45,7 %), средний возраст составил 70 лет, с диагнозом ОНМК по ишемическому типу. Для оценки тяжести неврологической симптоматики применялась шкала NIHSS [13]. Тромболитическая терапия (ТЛТ) проведена у 54% пациентов (n=94). Эндоваскулярная тромбоэкстракция (ТЭ) была выполнена у 16% пациентов (n=28). Для оценки взаимосвязи между величиной оценки по NIHSS и выявляемостью тромбоза интракраниальных артерий с помощью КТА был проведен анализ ранговых корреляций по Спирмену. Результаты исследования. У 63 пациентов (36%) оценка по шкале NIHSS составила от 0 до 6 баллов, у 110 человек (64%) — от 7 баллов и более. Окклюзия крупных интракраниальных артерий выявлена у 29% пациентов (n=50), из них только 28 (56%) дошли до этапа ТЭ. ТЛТ была проведена в 54% случаев (n=94). Среди пациентов с выявленным тромбозом интракраниальных артерий при КТА (n=50) доля имеющих показатель по шкале NIHSS до 6 баллов включительно составила 4% (n=2). Выявляемость тромбоза интракраниальных артерий по данным КТА в этой группе пациентов составила лишь 1,2% от общего числа обследуемых. Остальные 96% пациентов (48 из 50) с окклюзиями интракраниальных артерий по КТА были оценены по шкале NIHSS от 7 баллов и более. Выявлена положительная корреляция между показателями шкалы NIHSS и выявляемостью тромбоза интракраниальных артерий (коэффициент корреляции Спирмена составил 0,55; р На одного пациента, дошедшего до этапа ТЭ, пришлось 6 исследований КТА экстра- и интракраниальных артерий. Заключение. Оценка по шкале NIHSS коррелирует с наличием тромбоза интракраниальных артерий, выявляемому по КТА. При низких значениях NIHSS (менее 6 баллов) вероятность тромбоза крайне мала. Целесообразно назначать КТА пациентам с оценкой по шкале NIHSS от 7 баллов и более.

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The Entry Lag of Innovative Drugs in Russia, 2010–2019

2021 · ARTICLE · en

Objective: Evaluation of the lag timelines for the launch of innovative drugs to the Russian market and pharmacoeconomic factors they can depend on. Methods: To complete the investigation, we used information about drug products, namely, dates of submission and approval, and pharmacological groups recovered from national registers and official databases. Results: Due to impacts of market factors and imperfection of the state regulation, original drugs developed abroad enter the Russian market a few years after their registration in the United States of America, the European Union, and Japan. The average time from the moment of initial approval of a drug in the aforementioned countries and jurisdictions to the moment of registration in Russia is 4 years and 8 months, with a median value of 2.5 years. It has been shown that half of this term is spent on the performance of the procedures of the expertise of the drug registration dossier in the Russian Federation. Conclusion: To attain the goal of adequate supplies to the population of the Russian Federation of the most up-to-date, high quality, safe, and efficacious medications, apart from the support of national originators of innovative drugs, we are required to upgrade the existing system of original drug registration. Improvement should be primary focused on the drugs already approved by the leading national regulatory authorities in order to ensure innovative medicine access for Russian patients

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Hearing loss prevalence and years lived with disability, 1990–2019: findings from the Global Burden of Disease Study 2019

2021 · ARTICLE · en

Background Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. Methods We did systematic reviews of population-representative surveys on hearing loss prevalence from 1990 to 2019. We fitted nested meta-regression models for severity-specific prevalence, accounting for hearing aid coverage, cause, and the presence of tinnitus. We also forecasted the prevalence of hearing loss until 2050. Findings An estimated 1·57 billion (95% uncertainty interval 1·51–1·64) people globally had hearing loss in 2019, accounting for one in five people (20·3% [19·5–21·1]). Of these, 403·3 million (357·3–449·5) people had hearing loss that was moderate or higher in severity after adjusting for hearing aid use, and 430·4 million (381·7–479·6) without adjustment. The largest number of people with moderate-to-complete hearing loss resided in the Western Pacific region (127·1 million people [112·3–142·6]). Of all people with a hearing impairment, 62·1% (60·2–63·9) were older than 50 years. The Healthcare Access and Quality (HAQ) Index explained 65·8% of the variation in national age-standardised rates of years lived with disability, because countries with a low HAQ Index had higher rates of years lived with disability. By 2050, a projected 2·45 billion (2·35–2·56) people will have hearing loss, a 56·1% (47·3–65·2) increase from 2019, despite stable age-standardised prevalence. Interpretation As populations age, the number of people with hearing loss will increase. Interventions such as childhood screening, hearing aids, effective management of otitis media and meningitis, and cochlear implants have the potential to ameliorate this burden. Because the burden of moderate-to-complete hearing loss is concentrated in countries with low health-care quality and access, stronger health-care provision mechanisms are needed to reduce the burden of unaddressed hearing loss in these settings.

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Data discrepancies and substandard reporting of interim data of Sputnik V phase 3 trial

2021 · ARTICLE · en

Restricted access to data hampers trust in research. Access to data underpinning study findings is imperative to check and confirm the findings claimed. It is even more serious if there are apparent errors and numerical inconsistencies in the statistics and results presented. Regrettably, this seems to be what is happening in the case of the Sputnik V phase 3 trial. 1

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История популяционного здоровья

2021 · ARTICLE · ru

Рецензия на монографию Йохана Макенбаха, освещающего историю и механизмы формирования здоровья и долголетия популяций Европы в течение двух столетий.

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Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019

2021 · ARTICLE · en

Background Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (U5MR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings Global U5MR decreased from 71·2 deaths per 1000 livebirths (95% uncertainty interval [UI] 68·3–74·0) in 2000 to 37·1 (33·2–41·7) in 2019 while global NMR correspondingly declined more slowly from 28·0 deaths per 1000 live births (26·8–29·5) in 2000 to 17·9 (16·3–19·8) in 2019. In 2019, 136 (67%) of 204 countries had a U5MR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030, 154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9·65 million (95% UI 9·05–10·30) in 2000 and 5·05 million (4·27–6·02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3·76 million [95% UI 3·53–4·02]) in 2000 to 48% (2·42 million; 2·06–2·86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0·80 (95% UI 0·71–0·86) deaths per 1000 livebirths and U5MR to 1·44 (95% UI 1·27–1·58) deaths per 1000 livebirths, and in 2019, there were as many as 1·87 million (95% UI 1·35–2·58; 37% [95% UI 32–43]) of 5·05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve U5MR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress.

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Use of multidimensional item response theory methods for dementia prevalence prediction: an example using the Health and Retirement Survey and the Aging, Demographics, and Memory Study

2021 · ARTICLE · en

Background Data sparsity is a major limitation to estimating national and global dementia burden. Surveys with full diagnostic evaluations of dementia prevalence are prohibitively resource-intensive in many settings. However, validation samples from nationally representative surveys allow for the development of algorithms for the prediction of dementia prevalence nationally. Methods Using cognitive testing data and data on functional limitations from Wave A (2001–2003) of the ADAMS study (n = 744) and the 2000 wave of the HRS study (n = 6358) we estimated a two-dimensional item response theory model to calculate cognition and function scores for all individuals over 70. Based on diagnostic information from the formal clinical adjudication in ADAMS, we fit a logistic regression model for the classification of dementia status using cognition and function scores and applied this algorithm to the full HRS sample to calculate dementia prevalence by age and sex. Results Our algorithm had a cross-validated predictive accuracy of 88% (86–90), and an area under the curve of 0.97 (0.97–0.98) in ADAMS. Prevalence was higher in females than males and increased over age, with a prevalence of 4% (3–4) in individuals 70–79, 11% (9–12) in individuals 80–89 years old, and 28% (22–35) in those 90 and older. Conclusions Our model had similar or better accuracy as compared to previously reviewed algorithms for the prediction of dementia prevalence in HRS, while utilizing more flexible methods. These methods could be more easily generalized and utilized to estimate dementia prevalence in other national surveys.

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Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990–2050

2021 · ARTICLE · en

Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$ per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached $8·8 trillion (95% uncertainty interval [UI] 8·7–8·8) or $1132 (1119–1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total, $40·4 billion (0·5%, 95% UI 0·5–0·5) was development assistance for health provided to low-income and middle-income countries, which made up 24·6% (UI 24·0–25·1) of total spending in low-income countries. We estimate that $54·8 billion in development assistance for health was disbursed in 2020. Of this, $13·7 billion was targeted toward the COVID-19 health response. $12·3 billion was newly committed and $1·4 billion was repurposed from existing health projects. $3·1 billion (22·4%) of the funds focused on country-level coordination and $2·4 billion (17·9%) was for supply chain and logistics. Only $714·4 million (7·7%) of COVID-19 development assistance for health went to Latin America, despite this region reporting 34·3% of total recorded COVID-19 deaths in low-income or middle-income countries in 2020. Spending on health is expected to rise to $1519 (1448–1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all.

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Global, regional, and national mortality among young people aged 10–24 years, 1950–2019: a systematic analysis for the Global Burden of Disease Study 2019

2021 · ARTICLE · en

Background Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10–24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10–24 years by age group (10–14 years, 15–19 years, and 20–24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10–24 years with that in children aged 0–9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10–24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017). Findings In 2019 there were 1·49 million deaths (95% uncertainty interval 1·39–1·59) worldwide in people aged 10–24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or maternal causes; 27·0% were due to non-communicable diseases; and 8·2% were due to self-harm. Since 1950, deaths in this age group decreased by 30·0% in females and 15·3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10–14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15–19 years was 1·3% in males and 1·6% in females, almost half that of males aged 1–4 years (2·4%), and around a third less than in females aged 1–4 years (2·5%). The proportion of global deaths in people aged 0–24 years that occurred in people aged 10–24 years more than doubled between 1950 and 2019, from 9·5% to 21·6%. Interpretation Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10–24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group.

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Курсы (10)