Abstract
<jats:p>This article presents a conceptual framework for a rationale for telemedicine support to promote socio-demographic sustainability in the rural and remote regions of the Russian Federation. The relevance of the research is due to the structural limitations of the traditional model for organizing social and medical services, where a lack of human resources, poor territorial accessibility to specialized care, and gaps in continuity between levels of medical and social services create persistent obstacles to maintaining public health. The empirical base was formed from the materials of field sociological research conducted by the authors through interviews with experts from different regions of the country. These included representatives from hard-to-access and Arctic areas, as well as official statistics from Rosstat (Federal State Statistics Service) and the Ministry of Health of Russia. As a result, three key principles have been substantiated that underpin the concept of integrating telemedicine technologies into all levels of healthcare and social services, from medical and health posts to regional centres. Accessibility is understood as a unity of territorial, socioeconomic, and technological components. Preventive measures are aimed at early detection of disease and preservation of labour potential in the population. A three-tiered model of a telemedicine system was developed, the institutionalization of "telemedicine coordinators" was justified to overcome the digital divide, and special socio-demographic indicators were proposed (dynamics of the reduction of premature mortality from preventable causes, narrowing the gap in life expectancy between urban and rural areas). The novelty of this work lies in substantiating telemedicine technologies as a systemic element of socio-demographic stability in rural and remote areas rather than a supplementary tool. The practical significance lies in the possibility of using the developed concept to form regional healthcare development programmes and update socio-demographic policies in the constituent entities of Russia. The limitations of the study relate to the regional specifics of expert assessments, and the need to further test the proposed model in pilot regions in rural and remote areas.</jats:p>