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

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.

Download Full-text

Medical care for children with cancer in the Central Federal District

Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) ◽

10.21508/1027-4065-2018-63-5-75-82 ◽

2018 ◽

Vol 63 (6) ◽

pp. 75-82 ◽

Cited By ~ 1

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.

Download Full-text

Organization of medical care for children with cancer in the central federal district

Siberian Journal of Oncology ◽

10.21294/1814-4861-2019-18-2-5-14 ◽

2019 ◽

Vol 18 (2) ◽

pp. 5-14 ◽

Cited By ~ 1

Author(s):

M. Yu. Rykov

Keyword(s):

Mortality Rate ◽

Medical Care ◽

Russian Federation ◽

Pediatric Oncology ◽

Federal District ◽

Children With Cancer ◽

Central Federal District ◽

Number Of Patients ◽

Hospital Beds ◽

The Russian Federation

Background. Planning the organization of medical care for children diagnosed with cancer as well as assessing the quality of care is based on the statistical data analysis.The purpose of the study was to analyze the main parameters characterizing medical care for children with cancer in the central Federal district.Material and methods. The reports of the executive authorities in the sphere of health protection of 18 subjects of the Russian Federation included into the central Federal district were analyzed for 2017.Results. The number of children aged 0–17 years was 6 824 049, the number of pediatric oncology departments was 9, the number of hospital beds for children with cancer was 464, the number of bed-days per year was 319.3. the number of physicians providing pediatric cancer care was 91, of them 64 (70.3 %) had a certificate of a pediatric oncologist. in 11 subjects of the Russian Federation, there were no departments of pediatric oncology, and in 1of them, there were no hospital beds for children with cancer. the number of patients newly diagnosed with cancer was 821. the number of patients who died of cancer was 156, of them 66 were diagnosed with cancer in 2017. the cancer incidence rate was 12 per 100,000 children aged 017 years; the mortality rate was 2.3 per 100,000 children aged 017 years. the one-year mortality rate was 8 %. the mean time taken to establish the diagnosis and the time interval between diagnosis and initiation of treatment was unknown, since the reports did not contain precise information. twelve (1.5 %) patients left the territory of the Russian Federation for receiving treatment outside the Russian Federation.Conclusion. The information provided in most reports was not statistically reliable. the cancer incidence rates were significantly lower than those in countries with high statistical reliability. For reliable estimation of the number of inpatient beds for children with cancer and the percentage of children referred for the treatment to the federal medical centers, it is necessary to implement a unified database for pediatric oncology in the Russian Federation.

Download Full-text

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

Oncopediatrics ◽

10.15690/onco.v5i3.1933 ◽

2018 ◽

Vol 5 (3) ◽

pp. 155-163 ◽

Cited By ~ 1

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.

Download Full-text

Medical care for children with cancer in the Siberian Federal District

Siberian Journal of Oncology ◽

10.21294/1814-4861-2019-18-1-5-12 ◽

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.

Download Full-text

Analysis of the availability and direction of improvement of medical care for patients with malignant neoplasms in the Moscow region

Research n Practical Medicine Journal ◽

10.17709/2409-2231-2018-5-4-11 ◽

2018 ◽

Vol 5 (4) ◽

pp. 106-117

Author(s):

E. Yu. Ogneva ◽

A. N. Gurov ◽

M. V. Pirogov ◽

E. V. Gameeva ◽

O. Yu. Aleksandrova

Keyword(s):

Medical Care ◽

Cancer Patients ◽

Russian Federation ◽

Federal District ◽

Moscow Region ◽

High Tech ◽

Malignant Neoplasms ◽

Patients With Cancer ◽

The Subject ◽

The Russian Federation

Purpose. Carrying out medical and statistical analysis of morbidity and mortality of the population with malignant neoplasms, development of proposals for greater accessibility and areas of improvement of specialized including high-tech medical care (HTMC) for patients with cancer in the Moscow region.Materials and methods. The analysis of morbidity and mortality of the population of the Moscow region from malignant neoplasms and the organization of specialized, including high-tech, medical care to cancer patients on the basis of forms of Federal state statistical observations in relation to the three-level system of the organization of medical care to the population of the region with identification of organizational and financial problems.Results. The incidence of malignant neoplasms in the Moscow region in 2017 amounted to 364.9 per 100 thousand population, which is 1.0% below the level of 2016-365.9 per 100 thousand population and below the average for the Central Federal district and the Russian Federation. The mortality rate from neoplasms in the Moscow region decreased in 2017 to 174.7 cases per 100 thousand population, which is less than the average for the Central Federal district — 207.1 and the Russian Federation — 196.9 per 100 thousand population. At the same time, the volume of specialized medical care (including high — tech medical care) for malignant tumors, in a 24-hour hospital is more than twice the average Russian standard — 13% for SMC and 50% for HTMC. Exceeding the standard of medical care is mainly due to the HTMC 2, which is not planned in the subject of the Russian Federation and is usually in Federal clinics. The share of oncological medical care received outside the medical organizations of the MR is 16%, which exceeds the share of medical care in all other profiles received outside the Moscow region (12%). This situation contributes to the availability of cancer care to the population of the Moscow region.Conclusion. The performed work allowed to draw conclusions that in normative legal acts of Federal level it is necessary to define separately the standard of volumes of specialized, including hi-tech medical care, on the profile of Oncology. Large volumes of HTMC cannot be an unambiguous characteristic of the availability of medical care in General, since HTMC is medical care with the use of complex methods of diagnosis and treatment in clinically complex cases. Large volumes of HTMC can be a consequence of the complexity of clinical cases, but also a consequence of neglect of the disease due to the lack of diagnosis and treatment in the provision of primary health care (PHC) at the 1st level. In the Moscow region, there is a need to redistribute the volume of this medical care not only to cancer dispensaries, but also to other medical organizations. After that, there is a need for the distribution of patients, taking into account the morbidity in the territories, the place of residence of citizens, and taking into account the capabilities of medical organizations for the treatment of cancer patients (surgical treatment, chemotherapy, radiotherapy). Medical organizations of the subject of the Federation shall be ranked taking into account the applied technologies and opportunities of drug therapy. As a result, a clear routing of patients with cancer should be developed in the subject of the Russian Federation.

Download Full-text

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

Russian Journal of Oncology ◽

10.18821/1028-99842016-21-3-146-150 ◽

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.

Download Full-text

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

Oncopediatrics ◽

10.15690/onco.v5i4.1966 ◽

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.

Download Full-text

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

Oncopediatrics ◽

10.15690/onco.v5i4.1967 ◽

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.

Download Full-text

CHARACTERISTICS OF PRIMARY DISABILITY DUE TO DORSOPATHIES IN MOSCOW FOR 2013-2016

Medical and Social Expert Evaluation and Rehabilitation ◽

10.18821/1560-9537-2017-20-4-201-203 ◽

2017 ◽

Vol 20 (4) ◽

pp. 201-203

Author(s):

Sergey P. Zapariy ◽

O. A Lescay ◽

A. N Krytogolov ◽

E. M Sidorova ◽

A. Yu From

Keyword(s):

Russian Federation ◽

Adult Population ◽

Federal District ◽

Age Group ◽

Central Federal District ◽

Severity Of Disability ◽

Primary Disability ◽

The Russian Federation ◽

Analysis Of Dynamics

The article presents statistical material for the analysis of dynamics of primary disability due to dorsopathies among the adult population of Moscow, on age group and severity of disability in comparison with the figures for the Central Federal district and the Russian Federation for 2013-2016.

Download Full-text