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The aim of the study is to identify directions for reducing the pediatric out-of-hospital mortality rate of children and adolescents. Materials and methods. Within the framework of the federal project “Development of a network of national medical research centers and the introduction of innovative medical technologies” an analysis of 1,343 out-of-hospital deaths of children aged from 0 to 17 years occurred in 2019 in 30 regions of the Russian Federation was carried out. The causes of pediatric deaths were studied in various age groups: at the age of 0-27 days, 28-365 days, 1-4 years, 5-9 years, 10-14 years, and 15-17 years. Results. It has been established that every third deceased child aged from 0 to 17 years dies out-of-hospital (at home or elsewhere). In the age structure of pediatric deaths at home, the largest proportion was infants under the age of 1 year of life, in other places - teenagers aged 15-17 years. The main causes of pediatric out-of-hospital deaths at the age of 0-4 years were sudden infant death and others, inaccurately indicated and unspecified causes of death, at the age of 4-9 years - drowning and others, inaccurate and unspecified causes of death, at the age of 10-14 years - asphyxia and drowning, at the age of 15-17 years - asphyxia. In other words, all of them were more or less socially conditioned. A significant proportion of deaths from unidentified causes and sudden death, including sudden cardiac death and death as a result of cardiac arrest, were noticed. Conclusion. The social conditionality of the causes of pediatric out-of-hospital deaths should determine the directions for its prevention. The role of the health care system can be to organize effective modern technologies of medical and social support for children and to comply with the principles of intersectoral and interdepartmental interaction.

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