Background: The development of a country is often measured by the state of human development, especially maternal and child health indicators. In Mongolia, public health policies targeting the prevention of non-communicable diseases related to lifestyle and physical development among adolescents are critically needed. However, there is a lack of regional studies on adolescent health, particularly in rural areas. Aim: To study certain physical development indicators among adolescents in Bulgan province. Materials and Methods: This analytical study was conducted in 2022 involving 781 twelve-year-old children. Data were collected from parents and processed using Stata 17.0. Percentages were calculated for qualitative data, and Chi-square and Fisher’s exact tests were used for statistical analysis. Where statistically significant, multinomial logistic regression analysis was applied to identify risk factors affecting physical development. Results: 52.88% of the participants were boys,92.45% lived in traditional or private hous12.04% of the children showed growth retardation. 49.68% were overweight.70.94% were classified as overweight or obese based on their Body Mass Index (BMI).Weak muscle strength (1.66%), flexibility (2.05%), endurance (1.66%), and agility (1.92%) were observed. Boys were more likely to experience height retardation but had stronger muscle strength.Girls showed a higher prevalence of being overweight.Children living in the provincial center had higher height and BMI, while those in soum centers demonstrated statistically significant strength in muscle power, flexibility, and endurance. Conclusion 1. Among the study participants, 70.94% of children were overweight or obese. 2. 1.66% of the study participants had weak muscle strength, 2.05% had weak flexibility, 1.66% had weak endurance, and 1.92% had weak speed and agility. 3. The use of mobile phones, parental involvement, inactivity, lack of sports, and lack of horse riding have negative effects on physical development.

Background: A particular appealing problem in the medical field of our country is non-communicable diseases, which are derived from child development and lifestyle, prevention and the decision was approved on being used the maternal and child health handbook in order to be promptly needed the publicly covered medical policy toward those. Several researchers have noted that in developed countries longitudinal studies are used for checking and controlling in wide range of epidemic diseases and health issues for maternal and child, pregnancy and postpartum period as well as this method is directed to be found out multiple information and knowledge. Not having studied enough how well current situations for postpartum period and maternal and child health in our countryside is become the foundation for our research work. Moreover, it needs to be found out what kind of factors, which are effected on children who were born to the year of 2010 in Bulgan province, where it started using the first and only maternal and child health handbook (so called a pink handbook) in Mongolia, health issues. Also, the foundation of this study was to be needed to focus on our attention to which level of the medical field in order to improve those generations health issues are improved, Aim: to evaluate of a written usage of the maternal and child health handbook, to define its needs, to advertise its results to the public. Materials and Methods: The study is made with a cohort design of an analytical method based on collected information in 2013, of mothers and children, who are in need, giving birth and being born in 2010 and the results were made on Stata 17 program. The answers were taken with the base study of 2013 from 1015 original case sources within study groups in needs, and collected information covered with current and actual local situation, as well as to be involved in mothers and children, who gave birth and were born in 17 sums’ health institutions of Bulgan province. Results: Participants age range and educational backgrounds; 70.34 % of mothers were between 20-34 ages, 29.36% of mothers were 35 and over ages. 1.51% of uneducated mothers, 39.06 % of high school graduates, 49.1% of permanent residents, 45.38 % of temporary or nomadic or the smallest units residents of administration, 92.08% of married, 39.88% of families are consisted in members over 5, 52.12% of boys with average weights of 3389.8 grams during the period of being born, 9.86% of heavy pregnancy or heavy weight fetuses, 4.14% of light weight fetuses or light weight infants. Plus, the study was defined the mothers educational background to be great and helpful strength to use and record and to define the usages of the maternal and child health handbook, which was given and thoroughly explained to the mothers at the beginning. The leading diseases and their reasons were among three-year aged children, who were covered and recorded with 173 severe burnt, 42 falling injuries from something, 22 being hit and 19 were bitten by animals. In this study there were 17.83% of participants without the maternal and child health handbooks (pink handbooks), 81.77% of participants carried their pink handbooks with them when they went to the health facilities, 68.47% of them, who were gotten explanations from the doctors, when the pink handbooks were opened by, 71.72% of participants answered the pink handbooks to be needed. The results of this study have indicated that 71.72% of mothers, who used it at first time, answered the maternal and child health handbooks were very important and handy for understanding to check and observe for mothers and children’s development and growth. Conclusion It was the leading reason, which was predominantly recorded with cases of burning, falling injuries, hit and bitten by animals among three-year of children, who were participated in this study. There were high amounts of respiratory diseases and diarrheas among toddlers. 71.72% of participants considered that the maternal and child health handbooks were important.

Background: Accreditation of healthcare institutions serves as a fundamental mechanism for ensuring patient safety and validating the quality of medical services provided to the population. At Intermed Hospital, a quality measurement system for healthcare services has been established since 2015, encompassing 126 quality indicators at both institutional and departmental levels. This system facilitates continuous quality improvement efforts. In this context, quality indicators specific to the endoscopy department play a pivotal role in objectively assessing the quality of endoscopic services. Aim: To assess the quality indicators in gastrointestinal endoscopy unit. Materials and Methods: A retrospective single-center study was conducted by collecting data from the Intermed hospital’s electronic information systems which included HIS and PACS and Quality and Safety Department’s Database and the results were processed using the SPSS software. Ethical approval was granted by the Intermed hospital’s Scientific research committee. The quality of endoscopic services in the Intermed hospital was assessed based on: a) the average values of four quality indicators measured monthly; b) sample survey data from five categories of quality indicators. Results : Between 2016 and 2024, the quality indicators of the endoscopy unit measured as the level of early warning score evaluations for patients was 95.97%±3.33, the level of cases where peripheral blood oxygen saturation decreased during sedation was 1.54%±3.78, the level of cases where patients experienced paradoxiical response during sedation was 5.82%±1.75, surveillance culturing level for validation of endoscopy reprocessing was 11.6%. The endoscopic documentation quality by peer review showed 95.7-100%, the colonoscopy quality indicators were followings as adenoma detection rate: 24.5% Cecal intubation rate: 99.1%, 95.2%, Colonoscope withdrawal average time: 13.28±10.62 minutes, Bowel preparation quality (Boston Scale): 89.3% 95.7%), patient discharge from the recovery room, Average discharge time post-procedure: With propofol alone: 30.92 minutes; With propofol and fentanyl combined: 31.52 minutes, The intermediate risk was 0.28% by the TROOPS evaluation during procedural sedation. Conclusion The quality benchmark levels for these endoscopic units, as determined by a single-center study, can be effectively implemented by benchmark endoscopy centers to enhance their quality and safety operations.

Background: Saponins are secondary metabolites in plants that play an important role in defense mechanisms and physiological processes. Since stomatal cells are crucial for gas exchange and water balance in plant tissues, studying the anatomical and biochemical features of stomatal cells in saponin-rich plant species provides insight into the interactions between these compounds and cellular mechanisms. This serves as the basis of our study. Aim: To determine the structure, types, and functions of stomatal cells in saponin-containing medicinal plants Materials and Methods: During June–September 2024, nine species of saponin-containing medicinal plants were collected from Bulgan, Tuv provinces, and “Gorkhi-Terelj National Park” in Mongolia. Prepared microscopic specimens were examined using macroscopic and microscopic techniques to study the structure, position, number, and epidermal features of stomatal cells. Results: The study revealed that Anemone crinita Juz. exhibited the highest stomatal density (107 stomata/mm²) and epidermal cell density (229 cells/mm²), indicating strong adaptation and protective capacity in arid conditions. Vicia baicalensis (Turcz.) B. Fedtsch. showed the highest stomatal index (39.6), highlighting its significant role in regulating transpiration. Stomatal types varied among species: • Anomocytic stomata were observed in Potentilla multifida and Vicia baicalensis. • Anisocytic stomata were found in Delphinium grandiflorum and Ranunculus borealis. • Paracytic stomata were present in Gentiana algida, Adenophora remotiflora, Helianthemum nummularium, Anemone crinita, and Ranunculus acris. Conclution In the study of the structure, form, and number of stomatal cells in saponin-containing plants growing in Mongolia, Anemone crinita Juz. was found to have the highest number of stomatal and epidermal cells, indicating its high efficiency in gas exchange, water regulation, and protection against external stress. Furthermore, Vicia baicalensis (Turcz.) B.Fedtsch. showed the highest stomatal index, confirming its strong capacity for active regulation of gas exchange. The variation in stomatal cell types among plant species was identified as playing an important role in ecological and biological adaptation as well as protective mechanisms.

The clinical sign of children’s kidney and urinary tract petrification diseases and the result of eswl Background: A substance exchange disorder where stones form in the kidney or urinary tract with a tendency toward inheritance is called urinary tract petrification disease. In many countries throughout the world, the incidence of urinary tract petrification disease is one to fifteen percent. Urinary tract permeability disease affects 7% of people under the age of 17. Due to the unique nature of the habitat, the incidence of urinary tract petrification disease is higher in India, Thailand, Scandinavian countries, and the Caucasian, Ural, Siberia, and Equator areas. However, the incidence of urinary tract petrification disease spread is two to three percent for children, but the reoccurance risk is 6.5–54 percent. In our country’s case, J. Horloo’s 1993 research indicates that 4.1 to 4.7 percent of kidney and urinary tract patients have urinary tract disease. During urinary tract disease, the common symptoms are abdominal pain, macro- and microhematuria, and kidney and renal bacterial infection. But in younger children, those symptoms are quite grim. In the last 15 years, mongolian’s urine’s oxalate stone’s volume increased by 5 times and mixed stones decreased by 2.5 times. The research of G. Erdenetsetseg’s 1990–1998 study on 305 children and the 2001–2003 study on 161 children indicate that the incidence of urinary tract disease is high between ages 1-3, and 65 percent of the stones consist of calcium oxalate. In 1980, German scientists invented the stone crushing technology using electrohydraulic shockwaves, which turned out to be a beneficial treatment for kidney surgery practice. The National Hospital for Maternal and Child Health's kidney surgery team had 17 surgeries in 2015, 19 surgeries in 2016, 24 surgeries in 2017, and 28 surgeries in 2018, and all of those surgeries were done and treated open. In the last 10 years of our country, children’s urinary tract petrification disease has gradually increased, but research on those diseases risks and factors is lacking. Also, the stone crushing method is necessary for our country’s children's treatment. That’s why we decided to do research on the risk factors of urinary tract disease and its relation to the stone crushing method. Aim: Describe the features of children’s kidney and urinary tract petrification disease and study the stone crushing method’s results. Materials and methods: The study was done between December of 2019 and April of 2022, with the assistance of NCMCH's children's kidney surgery team. Within the parameter of the first objective, within the group of cases of kidney and urinary tract disease, there were 13 children under the age of 17. The research study was conducted cross sectional. The research results were processed by the SPSS 25 program. On the seventh meeting of the health ministry, we got the acceptance of a research patent with the assistance of EHEMUT. Results: The research group consisted of 13 children ages 0–17. The average age of participants was 10.6+-4.2.74. 4 percent of it consisted of men. The research of symptoms showed that back pain n = 13 (100), right side abdominal pain n = 13 (100), disurie n = 3 (23.1), mouth drying n = 2 (15.4), nausea n = 3 (23.1), urine with blood n = 10 (76.9), urine with smell n = 9 (69.2). The position of the stone consisted of 8 (61.5) in the kidney cup, 8 in the kidney cradle. Showing it in which kidney showed that 8 (61.5) were in the right kidney, 3 (23.1) in the left kidney, and 2 (15.4) in both kidneys. The density of the stones was n = 265.8+ 41.9 on average. Kidney stone coming out time was measured by Caplan-Myer’s survivability scale. The stones on the right side of the kidney came out within 14 days on average, while the left and both-sided kidney stones came out within 30 days. Conclusions: 1. Showing the number of stones and locations indicates that 8 (61.5) were in the right kidney, 3 (23.1) in the left kidney, and 2 (15.4) in both kidneys. 2. The results of Caplan-Meyer's scale indicate that kidney stones within the right kidney came out within 14 days, and left- or both-sided stones came out within 30 days.

Assessing children with disabilities using who international classification of functioning (ICF) Background: In 2021, according to the World Health Organization (WHO), over 1 billion people are estimated to experience disability. The number of children with disabilities globally is estimated at almost 240 million, according to a new UNICEF report. There are approximately 43 million children with disabilities in East Asia and the Pacific. In the 2020 population and housing census of Mongolia, a total of 106.4 thousand people with disabilities were counted, of which 7.6 percent or 8.1 thousand children aged 0-14 were counted. People with disabilities lose some of their ability to labor. WHO recommended that assessment of children with disabilities using both ICD and ICF. Thus, we aim to assess children with disabilities who have neurological disease using International Classification of Functioning and evaluate the validity of this classification. Materials and methods: This was a cross sectional analytical study based on NCMCH. Study materials were collected from children and guardians through standard questionnaires. The questionnaire consisted of 2 groups: general information of the participant and indicators of the scope of the D code of the "ICF" to assess the childhood disability. According to the indicators of the D code range, activity limitations and participation restriction, disabilities were evaluated. Each question in the questionnaire was measured on a 5-point Likert scale from 0 to 4. The statistical analysis was performed using R 3.5.1 program. Validity was assessed using the Rasch model for each question. Questionnaire reliability was assessed by Cronbach's alpha test. Results: The study included 32 children aged 2-15 years. Male children were 62.5% of participants, the mean age was 8±3.1 years. Correlation between questions was high (r = 0.79) and reliability was adequate (α=0.94). As a result of Rasch analysis, the mean and standard deviation of the 36 selected parameters were not significantly different from the standardized mean. 3 indicators that did not meet the analysis criteria were removed, and a total of 33 indicators were used to measure childhood disabilities. Mean infit MNSQ was 1.06, mean outfit MNSQ was 0.93. MNSQ of all participants were 1.0 – 2.0. As a result of Rasch analysis, the mean of 33 indicators of disability is -1.6, the standard deviation is 1.2, the upper limit of the mean is 3.6, and the lower limit is -3.4, and the indicator of D code was stable enough to measure disability. The mean code scores were 2.45±1.3. The mean score of disability level of children diagnosed with cerebral palsy was 2.9±1.09, and children hospitalized with seizures and meningitis was 0.5±0.3. Also, the total mean score was 2.61±1.2 in the group with disability and receiving care, and 1.8±0.21 in the group not receiving care, which was a statistically significant difference. Conclusions: Inter-indicator correlation was good and reliability of the questionnaire was adequate in field use of the 38 indicators of the activity limitations and participation restriction of the International Classification of Functioning, Children's Version (ICF-CY) code range “D”. When evaluated by Rasch analysis, 33 questions were evaluated as structural and stable. The International Classification of Functioning can be used to assess children's disabilities. Discussions: Niels Ove Illum et al. (2015) found that The World Health Organization International Classification of Functioning, Disability and Health child and youth version d code data can provide a coherent measure of severity of disability in children across various diagnoses, ages, and genders. Results were similar to our study.

Background: Endometriosis is a condition in which cells in the endometrium, layer of tissue normally covers uterine cavity, which grows outside to ovaries and other pelvic organs [1-4]. That may happen chronic pelvic pain, adhesion and pelvic organs dysfunction which leads to infertility later life [1-4]. In worldwide, 19-45 aged women have endometriosis, which is counted for 176 million, from 44% women have ovarian endometrioma [5]. In our country, 56% women received laparoscopic surgery due to ovarian cysts, which is diagnosed endometrioma. In recent years, ovarian endometriosis treated by synthetic progestin, gonadotropin analogues, combined contraceptive pills, intra-uterine device containing with progestin, and non-steroid anti-inflammatory drugs and laparoscopic surgeries [6, 7]. Serum antimullerian hormone (AMH) is key marker to define ovarian reserve, which correlates ovarian number of antral follicle counts [6, 7]. Material and Methods: We studied 129 patients who has diagnosed with ovarian endometrioma, aged 20-46 years, using case-control study design. There are 4 groups with medication and surgeries.
Approval for the study was obtained from the review board and the ethics committee of MNUMS. All the recruited patients provided their informed written consents. Results: When treatment groups were compared, level of AMH before synthetic progestin therapy was 3.48±0.9 and after it 3.41±1.0 (p-0.456), and that was before non-steroid anti-inflammatory drugs 3.68±0.8 and after it 3.11±0.8 ng/ml (p-0.212). Before laparoscopic surgeries for severe endometrioma, average level of AMH was 2.3±1.8ng/ml for synthetic progestin therapy group and it was 1.68±0.2ng/ml (p-0.007) after surgical peeling of endometrioma. For patients of 4th group who had not taking oral synthetic progestin before laparoscopic surgeries average level of AMH was 3.11±1.88 ng/ml before surgery and it became 2.21±0.28 ng/ml (p-0.005). Level of СА-125 marker was before medical therapy for group 1 was 37,9±5,25 IU/ml and after therapy - 20,6±2,03 IU/ml. For group 2 it was 69,9±9,79IU/ml and 35.1±6.76 IU/ml respectively. Average level for group 4 before surgical treatment it was 96.6±36.6 IU/ml, and after surgery became 25.71±2.96 IU/ml, and that for group 3 was before surgery 102±29.1 IU/ml and decreased after surgery to 29.2±4.15 IU/ml.
There are significant reduction of pain in patients who received synthetic progestin (p=0.001) groups. Serum AMH were 3.48±0.9 before treatment and 3.41±1.0 after treatment respectively (p=0.456). Prior treatment of laparoscopic surgery with progestin 3 months, it decreases abdominal lower pain (p=0.001) and dysmenorrhea (p=0.001). Serum AMH level were 3.11±1.8 before surgery and 2.21±0.2 after surgery,respectively, (p=0.005). Conclusion
1. There were little decrease in level of antimullerian hormone and less risk for ovarian reserve when mild endometrioma was treated with synthetic progestin and non-steroid anti-inflammatory drugs in two groups.
When severe and middle degree of endometrioma was treated with laparoscopic surgery there were significant decrease of antimullerian hormone, but it was less in group that had synthetic progestin therapy before surgery and it was more effective that surgical therapy without preparation.
2. Comparison of Serum level of СА-125, marker of ovarian tumor, was decreased less in group of non-steroid anti-inflammatory drugs, and was decreased more or it was more effective.

Introduction: PCOS prevalence is 5-10 percent among reproductive age women in worldwide. It is caused by imbalance of sex hormones which ultimately leads to menstrual irregularities, infertility, anovulation and other metabolic disturbances. Most women with chronic anovulation is caused by polycystic ovary syndrome [PCOS] The Rotterdam criteria is useful diagnostic tool for PCOS. In Mongolia there is almost no study on PCOS related infertility and there are increasing trend infertility among reproductive aged women with PCOS, lead us to conduct the study. Objective: The aim of this study was to estimate incidence of PCOS and to study clinical and biochemical characteristics of PCOS among infertility women. Material and Methods: We used the cross-sectional and case control study designs. Total 1334 infertility women enrolled in this study. The study was conducted after approval from the Ethical and research review board of the hospital, and written informed consent was taken from all the women. Among 114 women with PCOS were found by Rotterdam’s criteria at the Infertility and reproductive department, National Center for Maternal and Child Health, between December, 2018 - 2019. Total of 43 females with PCOS were screened among 1334 infertile women. All parameters were assessed either with ELISA in 43 infertile PCOS women and 17 age matched apparently healthy controls diagnosed according to Rotterdam consensus. IDF diagnostic criteria for MS was used. The PCOS patients divided into following groups: (1) with MS ( n=42) and (2) without MS (n=72). Results: The main age, body mass index (BMI), and duration of infertility were 28.7±4.1 years, 27.3±5.2 kg/ m² and 4.4±3.1y, respectively. Among patients 57.9% of them have oligomenorrhea, 22.8% with amenorrhea, primary infertility 57.0% and 51.9% with hirsutism and acne 50.8%. As a result of hormone assays were LH 9.3±3.5mIU/ml, LH/FSH 1.6 ±0.83 [0.1-3.6], AMH 6.1ng/ml ±3.6 /2.9-21.0/. The prevalence of MS was 36.8%. The variables including age (30.9±4.9), body mass (75.9±11.6kg) and also some metabolic parameters which is hypertension (133.6/88.4±13.6 mm Hg), WC (94.1±8.6 cm) and high triglyceride (1.8±1.0 mmol/l) were observed in MS group compared to without MS group. Conclusion Among 1334 women with infertility, the incidence of PCOS 8.7% (116), close to the prevalence in other countries. Considering the diagnose was confirmed of three criteria by the Rotterdam criteria. We found out that the prevalence of metabolic syndrome was 35.3% among infertility women with PCOS. Age, BMI, WC, amenorrhea, acne and acanthosis nigricans, were highly related to metabolic syndrome.

BACKGROUND: Acute myocardial infarction is leading cause of global morbidity and mortality and major health care burden in worldwide. Previous studies demonstrated that restoration of myocardial tissue perfusion after primary PCI is significant factor of improved outcome. In Mongolia, studying long term effects of primary PCI in patients with AMI and its’ association with coronary blood flow, tissue Doppler imaging, left ventricular global strain pattern in speckle-tracking echocardiography and risk factors are essential in theoretical and clinical practice. AIMS: To determine long term effects of primary PCI in patients with AMI and its’ association with left ventricular strain pattern in speckle-tracking echocardiography, risk factors and patient prognosis. METHODS: We used prospective cohort study design. We were selected 414 patients with AMI who treated by primary PCI between 2015 and 2016 at the State Third Central Hospital. Echocardiographic examination was conducted on Philips iE33 xMATRIX ultrasound machine. The PCI was performed according to the MNS:6379-2013 standard. RESULTS: Mean age was 60±13 and majority of them were male 84% (n=347). Complete coronary perfusion (TIMI-3) was achieved in patients 88% (n=367) after primary PCI. There was weak, negative correlation between coronary TIMI flow grade and left ventricular global longitudinal strain (r=-0.183, CI 95% -0.289 to-0.066, p<0.001). In patients with incomplete coronary perfusion (TIMI<3), mortality rate was significantly higher during 24 months follow-up. After primary PCI, 24 months mortality was 9.9% (n=39). Cut-off value of left ventricular global longitudinal strain which predict long term (within 24 month follow-up) mortality was -12.93% (sensitivity 74.4%, specificity 74.3%). Mortality during 24 months follow-up was significantly different between left ventricular global longitudinal strain groups (log-rank test p<0.001) and mortality was higher in left ventricular global longitudinal strain ≥ -12.93% group. CONCLUSION: Coronary no-reflow phenomenon is associated with long term mortality in patients with AMI. In patients with AMI who treated by PCI, long term mortality is predictable with left ventricular global longitudinal (≥-12.93%, p<0.001) strain.

Introduction: Cardiovascular diseases are one of the leading causes of mortality and morbidity in Mongolia during last 10 years. Accordingly, increasing number of the procedures cardiac open heart surgeries in Mongolia.The aim is to evaluate of the scientific literature related toestimation of expenditure for open heart surgeries.Method: The literature search strategies were developed to identify published studies. The following literature databases were searched and collected individually: MEDLINE PubMed, Google and abstract books in Mongolian libraries.Result: Analyzed the 28 published literatures which made in estimation of expenditures for open heart surgery. The most of the study were generally focused on the expenses of diagnosis and treatments of open heart surgery. Literature showed that for patients not covered by health insurance, valve replacement surgery typically costs from about $80,000 -$200,000 or more with an average, according to an American Heart Association report, of $164,238, not including the doctor fee. A surgeon fee can add $5,000 or more to the final bill. For example, Dartmouth-Hitchcock Medical Center in New Hampshire charges about $86,500, including doctor fee, after a 30% uninsured discount. St. Mary’s Hospital in Wisconsin charges an average of $107,000, but costs can reach $200,000 or more. AndBaptist Memorial Health Care charges about $75,000 -$140,000, not including doctor fee, but cost can go up to more than $200,000 with major complications. In Russia, total 700,000 people take surgery on annual average each year and on which they spend 10 902 500 000$ annually, it has been stated on Bokeriya.L found that 464 637.840 ruble annually on cardiac surgery coronary angioplasty surgery, 792 237 ruble on coronary heart disease surgery and 9 522 ruble on congenital heart defect repairment surgery. Up to per 15 years old children, 24 288 ruble spend on average. Bokeria et all reported that, expenses of medicine through ABC/VEN analysis, 47 types of medicines of A group(13.1% of total medicines) takes 79.62% of total expenses, 71 types of medicines of B group(19.8% of total medicines) takes 15.36% of total expenses, 242 types of medicines of C group(67.1% of total medicines) takes 5.02% of total expenses. Out of this report, N group’s portion of A group medicines takes 0.79% by VENanalysis. Approximate, all inclusive cost for open heart bypass surgery (CABG ) vary between USD 5500 - USD 7800, depending on the facility & city you chose to get the procedure done in India. D.Tsegeenjav and D.Bat-Undral reported the expenses on open heart surgery in Mongolia, as a result showed that health insurance spend 56 422 656 ₮ (appx 39,100,093$) for 156 numbers of procedures. But real cost expenditure was 440 300 000.00₮. It means health insurance spent 12.6% of total expenditure for procedures. Also health insurance expenditure for CABG and one valve replacement per patient were same as 643 272.00₮, but real expenditures for CABG was 2 000 000.00₮, and for one valve replacement surgery per patient was 5 000 000.00 ₮.Conclution: The scientific literatures showed that many studies related in estimation of expenditure for open heart surgery made in international countries such as Russia, USA, UK and India et all. But we didn’t found the study for estimation of expenditures for open heart surgery by using ABC/VEN analysis in Mongolia.References:1. Health indicators of Mongolia 2002-2012. Report of the state implementing agency.2. Цэгээнжав д, Бат-ундрал д. зүрхний нээлттэй мэс заслûн эмчилгээний зардлûн асуудалд, “авьяслаг шастинчууд 2013” эрдэм шинжилгээний хурлûн эмхэтгэл, х3-4Бокерия л. а.самородская и. в.ßрустовский и др., Oпыт применения авс- и ven-анализа в сердечно- сосудистой хирургии фгбу. Бюллетень нЦссх им. а.н. Бакулева рамн, 2012, ¹1, стр http://lekarius. ru/external/paper/26143. The European health report 2009: health and health system. WHO Library Cataloguing in Publication Data.4. Shear A, Scuffham P, Mollon P. The cost of coronary artery disease in the UK. Br. J. Cardiol. 2004. Vol. 11. P 218-223.5. Htt://health.costhelper.com/valve-replacement.html Heart valve replacement costKey words : Open heart surgery, expenditure