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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">prmed</journal-id><journal-title-group><journal-title xml:lang="ru">Первичная медико-санитарная помощь</journal-title><trans-title-group xml:lang="en"><trans-title>Primary Health Care (Russian Federation)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">3034-4123</issn><issn pub-type="epub">3034-4565</issn><publisher><publisher-name>LTD "Silicea-Poligraf"</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15829/3034-4123-2025-50</article-id><article-id custom-type="edn" pub-id-type="custom">EVLNCG</article-id><article-id custom-type="elpub" pub-id-type="custom">prmed-50</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ТЕРРИТОРИАЛЬНЫЕ ОСОБЕННОСТИ ОРГАНИЗАЦИИ  ПЕРВИЧНОЙ МЕДИКО-САНИТАРНОЙ ПОМОЩИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>TERRITORIAL FEATURES OF THE PRIMARY HEALTH CARE</subject></subj-group></article-categories><title-group><article-title>Повышение доступности первичной медико-санитарной помощи в труднодоступных регионах: опыт Республики Саха (Якутия)</article-title><trans-title-group xml:lang="en"><trans-title>Improving the availability of primary health care in hard-to-reach regions: the experience of the Sakha Republic (Yakutia)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Афанасьева</surname><given-names>Л. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Afanasyeva</surname><given-names>L. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., Министр здравоохранения Республики Саха (Якутия)</p><p>Якутск</p></bio><bio xml:lang="en"><p>Yakutsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Никитина</surname><given-names>А. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Nikitina</surname><given-names>A. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>главный врач</p><p>Якутск</p></bio><bio xml:lang="en"><p>Yakutsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Спиридонова</surname><given-names>Ю. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Spiridonova</surname><given-names>Yu. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>главный врач</p><p>Якутск</p></bio><bio xml:lang="en"><p>Yakutsk</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Оконешникова</surname><given-names>А. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Okoneshnikova</surname><given-names>A. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>зам. главного врача</p><p>Якутск</p></bio><bio xml:lang="en"><p>Yakutsk</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Попова</surname><given-names>Л. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Popova</surname><given-names>L. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>врач-методист</p><p>Якутск</p></bio><bio xml:lang="en"><p>Yakutsk</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Торонова</surname><given-names>А. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Toronova</surname><given-names>A. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>главный специалист-терапевт Департамента организации медицинской помощи населению</p><p>Якутск</p></bio><bio xml:lang="en"><p>Yakutsk</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2791-9933</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Портнягина</surname><given-names>У. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Portnyagina</surname><given-names>U. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н., доцент кафедры внутренних болезней и общеврачебной практики (семейная медицина), Медицинский институт</p><p>Якутск</p></bio><bio xml:lang="en"><p>Yakutsk</p></bio><email xlink:type="simple">ulyana-nsk@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кондрашова</surname><given-names>Н. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Kondrashova</surname><given-names>N. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н., доцент института терапии и инструментальной диагностики</p><p>Владивосток</p></bio><bio xml:lang="en"><p>Vladivostok</p></bio><email xlink:type="simple">nmk5@mail.ru</email><xref ref-type="aff" rid="aff-5"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Министерство здравоохранения Республики Саха (Якутия)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Ministry of Health of the Republic of Sakha (Yakutia)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ГБУ Республики Саха (Якутия) "Якутская Республиканская клиническая больница"</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Yakutsk Republican Clinical Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ГБУ Республики Саха (Якутия) "Республиканский Центр общественного здоровья и профилактической медицины"</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Republican Center for Public Health and Preventive Medicine</institution><country>Russian Federation</country></aff></aff-alternatives><aff xml:lang="ru" id="aff-4"><institution>"Северо-восточный федеральный университет им. М. К. Аммосова"</institution><country>Russian Federation</country></aff><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ФГБОУ ВО "Тихоокеанский государственный медицинский университет" Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pacific State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>28</day><month>07</month><year>2025</year></pub-date><volume>2</volume><issue>2</issue><fpage>27</fpage><lpage>33</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Афанасьева Л.Н., Никитина А.М., Спиридонова Ю.Е., Оконешникова А.И., Попова Л.В., Торонова А.К., Портнягина У.С., Кондрашова Н.М., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Афанасьева Л.Н., Никитина А.М., Спиридонова Ю.Е., Оконешникова А.И., Попова Л.В., Торонова А.К., Портнягина У.С., Кондрашова Н.М.</copyright-holder><copyright-holder xml:lang="en">Afanasyeva L.N., Nikitina A.M., Spiridonova Y.E., Okoneshnikova A.I., Popova L.V., Toronova A.K., Portnyagina U.S., Kondrashova N.M.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://prmed.elpub.ru/jour/article/view/50">https://prmed.elpub.ru/jour/article/view/50</self-uri><abstract><p>Повышение доступности специализированной медицинской помощи жителям населенных пунктов, расположенных в Арктической зоне Республики Саха (Якутия), без привлечения кадровых и материально-технических мощностей головных республиканских медицинских организаций. Основной задачей является: оценка состояния здоровья населения, в том числе на маршрутах кочевий коренных малочисленных народов севера (КМНС); раннее выявление заболеваний хронических неинфекционных заболеваний; отбор для оказания специализированной медицинской помощи, в том числе высокотехнологической медицинской помощи; организация диспансерного наблюдения, в том числе с использованием телемедицинских консультаций.</p></abstract><trans-abstract xml:lang="en"><p>Aim. To summarize the experience of the Sakha Republic (Yakutia) in improving the healthcare management in remote, hard-to-reach and sparsely populated areas.Material and methods. We used data from analytical and statistical reports of the Republican Center of Mobile Teams of the Sakha Republic (Yakutia) for 2022-2024, as well as regulatory documents on the primary healthcare (PHC) management in hard-to-reach regions.Results. The article considers current problems and directions for improving the availability of PHC to residents of hard-to-reach Arctic areas of the Sakha Republic (Yakutia). It is shown that the Republican Center of Mobile Teams, which has been operating since 2023, effectively solves the problems of healthcare provision in remote areas without involving the personnel and material and technical resources of the leading republican medical organizations. The mobile medical teams operating in the Arctic area of the republic are responsible for the following: assessing the population health status, including the nomadic routes of residence of indigenous peoples of the North; early diagnosis of noncommunicable diseases; identifying patients in need of specialized, including high-tech care; imaging follow-up monitoring, including the use of telemedicine consultations.Conclusion. Maintaining and strengthening the population health in Arctic areas of the Republic of Sakha (Yakutia) is a complex multifaceted task that requires significant resources and interdepartmental cooperation. In the conditions of a harsh climate, scattered settlements and low transport accessibility, providing the population with affordable and high-quality health care requires the development of a specialized area — Arctic medicine.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>первичная медико-санитарная помощь</kwd><kwd>мобильные врачебные бригады</kwd><kwd>диспансерное наблюдение</kwd></kwd-group><kwd-group xml:lang="en"><kwd>primary health care</kwd><kwd>hard-to-reach areas</kwd><kwd>sparsely populated areas</kwd><kwd>Arctic zone</kwd><kwd>mobile medical teams</kwd><kwd>telemedicine technologies</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Бекешова Э. Н. 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