The Results of the External Audit of Medical Care for Children with Cancer in one of the Regions of the Russian Federation

2016 ◽  
Vol 3 (2) ◽  
pp. 67-79
Author(s):  
M.Yu. Rykov ◽  
◽  
E.N. Baibarina ◽  
O.V. Chumakova ◽  
V.G. Polyakov ◽  
...  
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
External Audit ◽  
Children With Cancer ◽  
The Russian Federation

scholarly journals Medico-social study of the opinions of parents (legal representatives) on the medical care for children with cancer in the Russian Federation

2021 ◽  
Vol 66 (1) ◽  
pp. 87-93
Author(s):  
M. Yu. Rykov ◽  
O. A. Manerova ◽  
I. A. Turabov ◽  
V. V. Kozlov ◽  
V. A. Reshetnikov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Treatment Success ◽  
Social Study ◽  
Medical Personnel ◽  
Medical Organization ◽  
Children With Cancer ◽  
Oncological Diseases ◽  
The Russian Federation ◽  
To Receive

.Objective. To study the opinion of parents (legal representatives) on the problems of medical care for children with oncological diseases.Methods. The study was based on the Questionnaire for parents (legal representatives) on medical care children with cancer. The questionnaire consisted of 27 questions, the respondents were asked to choose one or several answers or to enter their own option.Results. This medical and social study demonstrated that 81.1±1.9% of respondents are not satisfied with the attitude of doctors and nurses towards them and their children, 15.9±1.8% of respondents are partially satisfied and only 3±0.8% of respondents are fully satisfied. The reasons for dissatisfaction were as follows: rude communication (35.8±2.4%), inadequate attention of medical personnel (21.3±2.0%) and lack of interest in the treatment success (19.7±2.0%). The combination of these options was noted by 23.2±2.0% of the respondents. 63.7±2.4% of respondents would prefer to treat their children at a medical organization of federal subordination, 33.9±2.4% – at medical organization outside the territory of the Russian Federation, of which 57.4±2.4% would like to receive a patient-oriented service and simplified routing between medical organizations during treatment. 12.7±1.6% mistrust in the qualifications of medical personnel in the Russian Federation, 11.8±1.6% of respondents indicated the lack of comfortable conditions for examination and treatment, 5.3±1.1% of respondents indicated the lack of necessary diagnostic and treatment methods and 12.8 1.6% of respondents indicated a combination of the above options.Conclusion. The results obtained indicate the need to implement patient-oriented approaches and to improve the routing of children with cancer.

Medical Care for Children with Cancer in the North-West Federal District of the Russian Federation: An Ecological Study

2018 ◽  
Vol 5 (3) ◽  
pp. 155-163 ◽  
Author(s):  
M. Yu. Rykov ◽  
I. A. Turabov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Care Delivery ◽  
Pediatric Population ◽  
Federal District ◽  
Children With Cancer ◽  
North West ◽  
The North ◽  
Bed Capacity ◽  
The Russian Federation

Background.Analysis of statistical data in the federal districts of the Russian Federation provides opportunities to assess the quality of medical care delivery in children with cancer and plan further development with consideration for the point elimination of existing defects. Objective. Our aim was to analyze the main indicators characterizing medical care for children with cancer in the North-West Federal District.Methods.The study analyzed operative reports for 2017 provided by the executive public health authorities of 11 subjects of the Russian Federation affiliated to the North-West Federal District.Results.The pediatric population was 2 537 133 children (0–17 years), the pediatric oncological bed capacity — 174 (0.7 per 10 000 aged 0–17 years), the annual berth average occupancy — 290.7 days. 6 (54.5%) subjects did not provide pediatric population with departments of pediatric oncology, 4 (36.4%) subjects did not have bed capacity. The number of practitioners providing medical care to children with cancer was 38, 27 among them (71%; 0.1 per 10 thousand 0–17 years) had a certificate of pediatric oncologist. 2 (18.2%) subjects did not have pediatric oncologists in the medical stuff. The incidence of malignant tumors in children aged 0–17 was 15.6 (per 100,000), the prevalence was 92.6 (per 100,000), the mortality rate was 2.6 (per 100,000), one-year mortality rate — 4.5% (18/397). The number of patients identified actively was 11 (2.8%). 160 (40.3%) primary patients were sent to Federal medical facilities, 6 (1.5%) — left the territory of the Russian Federation for the further treatment.Conclusion.The incidence and mortality rates are rather low which indicates the defects in patient detection and lack of reliable follow-up data. The percentage of patients referred for treatment to Federal medical facilities is not very high; however, to interpret this indicator according to patient routing, we have to analyze the medical history of all the patients. We can assert that health care delivery service for children with oncological diseases is at an acceptable standard level but needs to be improved. 

scholarly journals Medical care for children with cancer in the Siberian Federal District

2019 ◽  
Vol 18 (1) ◽  
pp. 5-12
Author(s):  
M. Yu. Rykov
Keyword(s):  
Mortality Rate ◽  
Medical Care ◽  
Russian Federation ◽  
Federal District ◽  
Siberian Federal District ◽  
Children With Cancer ◽  
Aim Analysis ◽  
Incidence And Mortality ◽  
Hospital Beds ◽  
The Russian Federation

background. The analysis of the quality of medical care for children with cancer is based on statistical data. Evaluation of the results obtained is also the basis of the strategy for the development of medical care for this category of patients. aim: analysis of the main parameters characterizing medical care for children with cancer in the Siberian Federal District. material and methods. The reports for 2017 on the health protection of 11/12 (91.6 %) constituent entities of the Russian Federation belonging to the Siberian Federal District were analyzed (Irkutsk Region did not provide data). results. In 2017 the number of children aged 0–17 years was 3 722 470, the number of pediatric hospital beds for children with cancer (ages 0–17 years) was 260 (0,7 per 10,000), and the average number of bed-days per year was 342.2. In 3 (25 %) constituent entities of the Russian Federation, there were no departments of pediatric oncology and in 1 (8,3 %) there were no hospital beds for children with cancer. The number of physicians, who specialized in children’s cancer was 49, of them 32 (65,3 %, 0,08 per 10,000, ages 0–17 years) had a certificate of a pediatric oncologist. In 1 (8,3 %) constituent entity of the Russian Federation, there were no pediatric oncologists. For children aged 0–17 years, the cancer incidence rate was 11.7 per 100,000 children, the cancer mortality rate was 2,2 per 100,000, and one-year mortality rate was 7,4 %. 188 (43,2 %) primary cancer patients were referred to medical institutions of the Federal District, and 17 (3,9 %) primary patients left the territory of the Russian Federation. conclusion. The low incidence and mortality rates can be explained by the lost of reliable follow-up data. It is advisable to introduce electronic health record systems. For reliable estimation of hospital bed supply for children with cancer and percent of patients referred to medical centers for treatment, it is necessary to carry out a clinical audit. Deficiency of pediatric oncologists should be eliminated by reforming the training of medical personnel.

scholarly journals Medico-social study on the opinions of parents on the problems of organizing medical care for children with cancer in the Russian Federation

2020 ◽  
Vol 19 (1) ◽  
pp. 53-59
Author(s):  
Maxim Y. Rykov ◽  
Olga A. Manerova ◽  
Ivan A. Turabov ◽  
Vasily V. Kozlov ◽  
Vladimir A. Reshetnikov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Social Study ◽  
Medical Personnel ◽  
Medical Organization ◽  
Children With Cancer ◽  
Oncological Diseases ◽  
The Russian Federation ◽  
Success Of Treatment ◽  
Patient Centric

To study the opinions of parents (legal representatives) on the problems of organizing medical care for children with oncological diseases, a medical and social study was conducted. This study aims to examine the opinions of parents on the problems of organizing medical care for children with oncological diseases. This study was conducted based on the developed questionnaire for recording the opinions of parents (legal representatives) on improving the organization of medical care for children with cancer. The questionnaire comprised 27 questions, in which the respondents were asked to choose one or more answer options for each of them. For objectivity, the questionnaires were filled in anonymously. This medical and social study showed that 81.1 1.9% of the respondents are not satisfied with the attitude of doctors and nursing staff toward them and their children, 15.9 1.8% are only partially satisfied, and 3 0.8% are fully satisfied (roughness in communication (35.8 2.4%), lack of sufficient attention from medical personnel (21.3 2.0%), and lack of interest in the success of treatment (19.7 2.0%)). The combination of these options was noted by 23.2 2.0% of respondents. As the preferred treatment site for their children, 63.7 2.4% of the respondents indicated a medical organization of federal subordination and 33.9 2.4% a medical organization located outside the territory of the Russian Federation, in which 57.4 2.4 % of the respondents mentioned the possibility of receiving a patient-oriented service and complex routing during treatment between the medical organizations in the Russian Federation as a reason for choosing. Furthermore, 12.7 1.6% of the respondents indicated a lack of confidence in the qualifications of medical personnel in the Russian Federation; 11.8 1.6%, the lack of comfortable conditions for examination and treatment; 5.3 1.1%, the lack of necessary diagnostic and treatment methods; and 12.8 1.6%, a combination of the listed options. Overall, the findings of this study indicate the need to further improve the organization of medical care for children with cancer: introducing patient-oriented approaches and improving patient routing to create a patient-centric health care system for organizing medical care for children with cancer are necessary.

Some indices characterizing medical care to children with cancer in the Russian Federation

2016 ◽  
Vol 21 (3) ◽  
pp. 146-150
Author(s):  
Maksim Yu. Rykov ◽  
N. A Susuleva ◽  
V. G Polyakov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Pediatric Oncology ◽  
Federal District ◽  
Controlled Study ◽  
High Tech ◽  
North Caucasus ◽  
Children With Cancer ◽  
The North ◽  
The Russian Federation

Introduction. The large size of the Russian Federation, different size and density of the child population in the regions of the country require for careful planning organization of care for children with cancer and the rational use of available resources, since in spite of the significant progress made in pediatric oncology, malignant neoplasms (External testing) are the second most common cause of the death in children. Purpose of the study. Perfection of the organizational-methodological approaches to care for children with cancer in Russia in order to improve the quality and effectiveness of treatment. Material and methods. In a non-randomized non-controlled study there were included reports of regional ministries and departments of health from 83 subjects of the Russian Federation for 2013. Results. The highest incidence rate of malignant tumors (per 100,000 ofpopulation agedfrom 0 to 17 years) was registered in the Lipetsk region - 21.7, the lowest - in the Republic of Tyva - 5.5. The number of patients newly diagnosed in 2013 was the highest in the Central and Volga Federal Districts - 775 and 653, respectively. The smallest - in the Far Eastern Federal District - 138. The number of primary patients referred to the federal clinic, was the largest in the North Caucasus Federal District (North Caucasus Federal District) - 80%, the lowest - in the South - 32.5%, the largest number of doctors who do not have primary specialization in “Children’s oncology”, was registered in the North Caucasus Federal District and the Volga Federal District - 50%, the lowest - Urals - 14.2%. Total in Russia 51 children’s oncological department operate, while the number of beds in which we treat these patients, including beds in non-core branches is 2021. 390 doctors treat children with cancer, out of which 252 (64, 6%) did not have a certificate in pediatric oncology. In 2013, 33 78 children were registered with the External testing, 1705 (50.5%) of them were directed for the management in federal clinics. Conclusion. It is necessary to improve further the existing vertical provision of high-tech medical care for children with cancer, the creation of regional cancer registers, certification of specialists and the quality control of medical care through the implementation of internal and external audit.

scholarly journals Medical care for children with cancer in the Central Federal District

2018 ◽  
Vol 63 (6) ◽  
pp. 75-82 ◽  
Author(s):  
M. Yu. Rykov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Pediatric Oncology ◽  
Conflict Of Interest ◽  
Federal District ◽  
Malignant Neoplasms ◽  
Age Group ◽  
Children With Cancer ◽  
Central Federal District ◽  
The Russian Federation

Relevance. Statistical indicators are the basis for planning of the organization of medical care for children with cancer, as well as analysis of the effectiveness of medical care. Materials and methods. The authors have analyzed operational reports for 2017 of the executive authorities in the field of health care of 18 objects of the Russian Federation being part of the Central Federal District. Results. There 9 pediatric oncology departments, there are 464 children’s oncological beds, the bed occupancy per yearis 319.3. There are 91 doctors providing medical care to children with cancer, 64 (70.3%) of the doctors have a certificate of pediatric oncologist. In 11 subjects there are no Departments for Pediatric Oncology. There are 821 primary patients with malignant neoplasms. There are 156 deceased patients, 66 of them were diagnosed in 2017. 52 (6.3%) patients are revealed actively. There were 12 (per 100 thousand for the age group of 0–17 years) cases of incidence of malignant neoplasms, mortality is 2.3 (per 100 thousand for the age group of 0–17 years), one-year mortality is 8%. The average time taken to diagnose and to verify the diagnosis before the beginning of treatment remains unknown. Conclusion. Operational reports contain non-matching indicators, thus, the information is not completely reliable. Incidence rates are significantly lower than those in countries with high reliability of statistical data. The percentage of patients identified actively remains extremely low. In order to eliminate the noted defects, it is necessary to introduce a single database of children with cancer in the Russian Federation.Conflict of interest: The author of this article confirmed the lack of conflict of interest and financial support, which should be reported.

Medical Care for Children with Cancer in the Russian Federation: Current Situation and Development Prospects

2019 ◽  
Vol 6 (1) ◽  
pp. 5-15
Author(s):  
Maxim Yu. Rykov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Pediatric Oncology ◽  
Malignant Tumors ◽  
Social Significance ◽  
Children With Cancer ◽  
Number Of Children ◽  
The Social ◽  
The Russian Federation ◽  
One Year

Background. The social significance of pediatric oncology and attention to the problems of treating children, both representatives of the authorities and the community, a small number of primary patients detected annually, a shortage of pediatric oncologists and pediatric oncological beds explain problems in organizing medical care for this category of patients. This requires a search for new approaches to the organization of medical care, based on scientific calculations. Objective. Our aim was to improve the organization of medical care for children with cancer in the Russian Federation. Methods: The operative reports for 2017 of executive bodies in the sphere of health care 81/85 (95.3%) of the subjects of the Russian Federation were analyzed. Results. The number of children was 28 132 685 people. (0–17 years), the number of child oncology departments — 47, children›s oncological beds — 1925 (0.7 for 10,000), the average number of days of berth employment in the year — 315.3 days. In 30 (35.3%) subjects of the department of pediatric oncology are absent, in 12 (14.1%) — there are no children›s oncological beds. The number of physicians that provide medical care to children with cancer — 392, of which 259 (66%, 0.09 for 10 thousand) have a certificate, a pediatrician oncologist. In 12 (14.1%) subjects, there are no doctors-children oncologists, 6 (7%) did not provide these data. In 6 (7%) subjects there are no children›s oncological beds and doctors-children›s oncologists. The incidence of malignant tumors was 13.2 (100,000 thousand) prevalence — 91.3, death rate — 2.5, a one-year lethality — 6.5%. Actually revealed 8.3% of patients. 1385 (37.4%) of primary patients were sent to medical organizations of federal subordination, 61 (1.6%) primary patients left the territory of the Russian Federation. Conclusion. It is necessary to take measures aimed at modernizing the system of rendering medical care to children with cancer, namely: to increase the reliability of statistical data, to analyze the needs of subjects in the number of children’s oncological beds and pediatric oncologists, to introduce criteria for selecting patients for children’s oncological beds as part of medical organizations of various levels, to minimize the deficit of doctors and children’s oncologists, to systematically increase the number of children’s cancer beds simultaneously dividing existing in accordance with the needs of the population and the level of congestion, as well as ensure the routing of patients in accordance with a three-tier model.

Medical Care for Children with Cancer in the North-Caucasian, Volga, Urals, Siberian and Far Eastern Federal Districts: An Ecological Study

2018 ◽  
Vol 5 (4) ◽  
pp. 214-237
Author(s):  
M. Yu. Rykov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Ecological Study ◽  
Medical Personnel ◽  
Malignant Neoplasms ◽  
Children With Cancer ◽  
The North ◽  
Federal Districts ◽  
The Russian Federation ◽  
Far Eastern

Background. The analysis of the quality of medical care for children with cancer is based on statistical data. Evaluation of the results is also the basis of the strategy for the development of medical care for this category of patients.Objective. Our aim was to analysie the main indicators characterizing medical care for children with cancer in the North-Caucasian, Volga, Urals, Siberian and Far Eastern Federal Districts.Methods. In ecological study the operative reports for 2017 of the executive authorities in the sphere of health protection of 44/48 (91.6%) subjects of the Russian Federation that are part of the listed above federal districts have been analyzed (Chuvash Republic, Irkutsk Region, Republic of Sakha (Yakutia) and Khabarovsk Territory did not provide data).Results. The number of children’s population was 15 555 306 people (0–17 years), the number of children’s oncological beds — 1166 (0.7 per 10 thousand 0–17 years), the average number of days of berth employment in the year — 324.6 bed days. In 13 (29.5%) subjects of the department of pediatric oncology are absent, in 6 (13.6%) — there are no children’s oncological beds. The number of doctors providing medical care to children with cancer is 213, of which 132 (62%; 0.08 for 10 thousand 0–17 years) have a certificate of a pediatric oncologist. In 6 (13.6%) subjects there are no doctors-children oncologists (6 more (13.6%) subjects did not provide data). The incidence of malignant neoplasms was 13.1 (per 100.000 0–17 years), the prevalence of 93.1 (per 100.000 0–17 years), mortality rate 2.5 (per 100.000 0–17 years), one-year lethality — 6.8%. 10.1% of patients were actively detected. 781 (38.3%) of primary patients were sent to medical organizations for federal subordination, 39 (1.9%) of primary patients left the territory of the Russian Federation.Conclusion. Obvious accounting defects (low incidence rate) and lack of reliable follow-up data (estimation of mortality levels is difficult) are eliminated by introducing electronic accounting systems. For reliable estimation of the level of provision of the population with children’s cancer beds and the percentage of patients sent for treatment in medical organizations of federal subordination, audit of patients’ illnesses is necessary. The traditional problems — the deficiency of doctors and children’s oncologists and a low percentage of patients identified actively — must be addressed through the reform of the training program for medical personnel.

Analysis of Some Indicators Characterizing the Quality of Medical Care for Children with Cancer in the South Federal District of the Russian Federation: An Ecological Study

2018 ◽  
Vol 5 (4) ◽  
pp. 238-247
Author(s):  
M. Yu. Rykov
Keyword(s):  
Medical Care ◽  
Russian Federation ◽  
Malignant Tumors ◽  
Federal District ◽  
The South ◽  
Children With Cancer ◽  
Number Of Children ◽  
Quality Of Medical Care ◽  
The Russian Federation

Background. Improving the quality of medical care is based on a coordinated policy at the federal, regional and municipal levels in the field of health. The implementation of this goal is based on a regular assessment of the current state of the healthcare system in the Russian Federation.Objective. Our aim was to analyse of the main indicators characterizing medical care for children with cancer in the South Federal District.Methods. The operative reports for 2017 of the executive authorities in the sphere of health protection of 8 subjects of the Russian Federation that are part of the South Federal District of the Russian Federation have been analyzed.Results. The number of children were 3 216 797 people (aged 0–17 years), the number of children’s oncological beds is 272 (0.8 per 10 thousand children aged 0–17 years), the average number of days of berth employment in the year is 289.9 bed days. In 4 (50%) subjects of the department of pediatric oncology are absent, in 1 (12.5%) — there are no children’s oncological beds. The number of doctors providing medical care to children with cancer is 50, of them 42 (84%, 0.1 per 10 thousand children aged 0–17 years) have a certificate of a pediatric oncologist. In 2 (25%) subjects, there are no pediatric oncologists. Incidence of malignant tumors was 13.9 (per 100,000 children aged 0–17 years), prevalence was 86.5 (per 100,000 children aged 0–17 years), mortality was 2.5 (per 100,000 children aged 0–17 years), a one-year mortality rate of 4.7%. 8% of patients were actively detected. 104 (23.2%) of primary patients were sent to medical organizations of federal subordination, 4 (0.9%) of primary patients left the territory of the Russian Federation.Conclusion. The analysis revealed a number of defects: incorrect information contained in the reports, low incidence (detectability) of patients, including during planned preventive examinations, staff shortages and non-rational use of bed facilities.

Analysis of Medical Care for Children with Cancer in the Central Federal District in 2017: Ecological Study

2018 ◽  
Vol 5 (2) ◽  
pp. 81-90 ◽  
Author(s):  
Maxim Yu. Rykov
Keyword(s):  
Mortality Rate ◽  
Medical Care ◽  
Russian Federation ◽  
Care Delivery ◽  
Federal District ◽  
Malignant Neoplasms ◽  
Age Group ◽  
Children With Cancer ◽  
Central Federal District ◽  
The Russian Federation

Background. Planning the management for medical care delivery for children with cancer, as well as analysis of the effectiveness of medical care delivery is based on the statistical indicators analysis.Objective. Our aim was to analyze the main indicators characterizing medical care delivery for children with cancer in the Central Federal District.Methods. The operative reports for 2017 provided by the executive health protection authorities of 18 subjects of the Russian Federation that are part of the Central Federal District have been analyzed.Results. The study enrolled the following data: number of children was 6 824 049 (0–17 years), pediatric oncological departments — 9, pediatric oncological beds — 464, days of berth employment per year — 319.3. The number of practitioners providing medical care to children with cancer was 91, 64 (70.3%) of them had a certificate of training as a pediatric oncologist. In 11 subjects, the department of pediatric oncology was not available; one of the districts did not provide any pediatric oncological beds. The number of primary patients with malignant neoplasms was 821. The number of deceased patients was 156 including 66 identified in 2017. The incidence of malignant tumors was 12 (per 100 000 for the 0–17 age group), the mortality rate was 2.3 (per 100 thousand for the age group 0–17 years), one-year mortality rate — 8%. We failed to reveal the average time from diagnosis establishing till its validation before the treatment onset since the reports did not provide precise information on the point. 12 (1.5%) primary patients left for treatment abroad.Conclusion. Most reports included indicators which lack congruity with one another. The incidence rates were significantly lower than those in countries with high statistical reliability. The percentage of patients identified actively remained extremely low. To improve the revealed defects a single database of children with oncological diseases should be implemented in the Russian Federation.

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