STATE SUPPORT FOR HEALTHCARE IN THE RUSSIAN FEDERATION

The article presents a systematic analysis of the mechanisms of state support for healthcare in the Russian Federation in the context of socio-economic transformation, sanctions pressure and demographic challenges. The purpose of the study is to evaluate the effectiveness of the current support model and develop recommendations for its transformation into a proactive, preventive and trusting ecosystem of public health. The methodological basis was an analysis of the dynamics of key indicators for the period 2020– 2025, including life expectancy, infant mortality, staffing levels and volumes of high-tech care, as well as an institutional analysis of the regulatory framework and policy documents. It is established that the implemented model demonstrates the transition from an infrastructural-bed paradigm to a result-oriented one, which is confirmed by a steady decrease in infant mortality (from 4,5% to 3,6%) and an increase in the volume of hightech care (from 1017 thousand to 1350 thousand operations). At the same time, critical imbalances have been identified: a projected decrease in the provision of doctors to 43,64 per 10 population by 2025 with a target of ≥45,0 by 2030, territorial unevenness in the distribution of human resources and the gap between the technological equipment of digital platforms and the level of social legitimacy of their use. The necessity of transforming the primary link into a health management center throughout the life cycle, introducing dynamic systems of geo-positioning personnel monitoring, rethinking digitalization as an infrastructure of trust, as well as expanding the effectiveness assessment system through indicators of subjective well-being and digital involvement of patients is substantiated. The proposed approach makes it possible to synthesize technological modernization with the strengthening of the social contract in healthcare, which corresponds to the global trend towards focusing systems on patient values.