Development and advancement of territorial disaster medicine service in historical perspective based on the analysis of regulatory documents per Russian Federation constituent (the case of a megacity)

Relevance. The existence of a well-developed regulatory and legal framework is a prerequisite for a functionally integral public healthcare system and disaster medicine in particular. Territorial disaster medicine services across Russian regions have witnessed a comprehensive multi-stage advancement, associated with the establishment and further improvement of the dedicated rules and regulations. The amended rules and regulations, aimed at establishing improved disaster medicine services, consider various medical and geographic parameters of every region, as well as its hazardous industrial facilities.

The study aim is to examine the dynamics and advancements of the disaster medicine in a historical perspective based on the retrospective analysis of regulatory documents issued by Moscow healthcare authority from 1990 to 2025, governing the territorial disaster medicine service of the region.

Materials and methods. We performed a retrospective analysis of nine major decrees issued by the Moscow healthcare authority characterizing the disaster medicine service and its activities from 1990 to 2025. The study utilized the historical and comparative methods, as well as systems analysis, correlation, and scientific generalization.

Results and analysis. The analysis of regulatory documents issued by the Russian regional healthcare authority under consideration revealed a strong dependence between the territorial disaster medicine service development and the quality of the regulations regarding its functionality. The improvements relied on the adoption of new regulations governing the service activities and its functional units, that were developed based on scientific findings and insights accumulated by medical organizations and territorial disaster medicine formations throughout the years of expertise in eliminating medical and sanitary consequences of emergencies.

Conclusion. Our retrospective analysis of regulatory documents issued by the Moscow healthcare authority allowed to split the development of the territorial disaster medicine service into three stages: establishing the emergency medical service (1990–1995); stagnated development of the emergency medical service (1996–2015); and establishing the territorial disaster medicine service (2016–2025).

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