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.

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 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.

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

2019 ◽  
Vol 18 (2) ◽  
pp. 5-14 ◽  
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.

scholarly journals Seasonal and regional features of the distribution of rotavirus incidence in the Russian Federation

2015 ◽  
Vol 20 (2) ◽  
pp. 52-54
Author(s):  
A. T Podkolzin ◽  
D. E Kurochkina ◽  
G. A Shipulin
Keyword(s):  
Russian Federation ◽  
Temporal Distribution ◽  
Federal District ◽  
North Caucasus ◽  
The North ◽  
Regional Features ◽  
Rotavirus Vaccines ◽  
Rostov Region ◽  
The Russian Federation ◽  
Nizhny Novgorod Region

In the work there was performed an analysis of the indices of recorded incidence of rotavirus infection (RVI) in the territory of 40 subjects of the Russian Federation for the period 2008-2012. For the identification of the monthly peak of the incidence there was evaluated the temporal distribution of the relative indices of the RVI incidence within each subject of the observation. There was revealed the independent beginning of the winter-spring seasonal rise of the RVI incidence in three groups of territories of the Russian Federation (1 - Kirov, Kostroma, Nizhny Novgorod region; 2- Republic of Khakassia, Kemerovo region; 3 - Amur region). In the territory of the South and the North Caucasus Federal District (Krasnodarsky and Stavropolsky Krai, Rostov region) there was noted the second, summer-autumn seasonal rise in the RVI incidence. The obtained data provide an overview of the seasonal-geographical distribution of the RVI incidence in the territory of Russia in conditions of the absence of the use of rotavirus vaccines

scholarly journals Epidemiological Situation on Tick-Borne Borreliosis in the Russian Federation in 2019 Compared to the Period of 2002–2018

2020 ◽  
pp. 131-138
Author(s):  
S. A. Rudakova ◽  
N. A. Pen’evskaya ◽  
A. I. Blokh ◽  
D. A. Savel’ev ◽  
O. E. Teslova ◽  
...  
Keyword(s):  
Russian Federation ◽  
Federal District ◽  
Effective Control ◽  
North Caucasus ◽  
North West ◽  
Main Research ◽  
The North ◽  
Federal Districts ◽  
The Russian Federation ◽  
Epidemiological Situation

Objective: to analyze the epidemiological situation on Ixodidae tick-borne borreliosis in the Russian Federation in 2019 in comparison with the period of 2002–2018.Materials and methods. The paper uses the data contained in Form No. 2 of the state statistical reporting for 2002–2019 and information obtained by the Reference Center for Monitoring Borreliosis of the Omsk Research Institute of Natural Focal Infections from 74 constituent entities of Russia in 2019. The main research method is epidemiological one with the use of modern information technologies.Results and discussion. In Russia, 8048 cases of tick-borne borreliosis (Lyme disease – LD) were recorded (5.48 0/0000) in 2019. The actual indicators of the LD incidence for the whole country and federal districts (FD) in 2019 were within the confidence limits predicted with linear regression based on the study of the dynamics of the epidemic process in 2002–2018 in the vast majority of cases. A steady upward trend in the LD incidence was observed during 2002–2019 in the Central Federal District due to 10 out of 18 entities (Moscow, Belgorod, Lipetsk, Moscow, Bryansk, Voronezh, Kursk, Ryazan, Tambov, Tula regions); in the Southern Federal District because of the Krasnodar Territory and the Volgograd Region; in the North Caucasus Federal District – because of the Stavropol Territory. Despite the fact that a downward trend in the incidence of LD has been established over the past 18 years in the North-West, Volga and Ural Federal Districts, in some subjects of these regions a trend towards an aggravation of the epidemiological situation is observed (the Komi Republic and Chuvashia, Penza Region). In the absence of a pronounced tendency to change in the incidence rate of LD in the Siberian and Far Eastern Federal Districts, Kemerovo Region-Kuzbass, the Republic of Tuva and the Trans-Baikal Territory where a growing trend has been identified require special attention. In the Ural and Siberian Federal Districts, the share of non-erythema forms among laboratory-confirmed cases of LD was higher than in other regions, which merits further study of the genome-specific features of borrelia populations and their carriers. Effective control of the LD epidemiological situation in Russia is possible provided that the control is improved and maintained, and the capacity of preventive measures and zoological-entomological monitoring of the activity and structure of the natural foci of LD is enhanced in the entities with the long-term tendency towards increase in the incidence of the disease. 

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

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.

scholarly journals The rationale for dislocation of interregional specialized surgical care centers for children in the Russian Federation

2020 ◽  
Vol 10 (3) ◽  
pp. 263-274
Author(s):  
Vladimir M. Rozinov ◽  
Dmitriy A. Morozov ◽  
Sergey A. Rumyantsev ◽  
Nikolay N. Vaganov ◽  
Vladimir I. Petlakh ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Medical Care ◽  
Russian Federation ◽  
Current System ◽  
Surgical Care ◽  
Federal District ◽  
Urgent Care ◽  
High Tech ◽  
Universal Method ◽  
The Russian Federation

Introduction. In Russia, there is a need to reorganize the system of providing specialized surgical care to children, primarily in emergency and urgent care and in remote, sparsely populated, and hard-to-reach areas. This need is evidenced by the significant persisting disparities in the mortality rate in the countrys various regions. Purpose of the study. This study aims to provide multifactorial substantiation of the expediency, profile, and location of specialized (surgical) interregional centers (MRC), including high-tech, medical care for children, by the priority profiles of activity, about medical organizations of the federal districts (FD) of Russia. Materials and methods. The study design included a two-level (regional and federal) system of professional expertise and justification in terms of the profile, location, and area of responsibility of the MRC in the federal district of the country. At the regional level, Delphi technology was implemented with a mathematical and statistical analysis of 103 expert opinions from 85 constituent entities of Russia, the result of which activities priority profiles were substantiated (newborn surgery, neurosurgery, thoracic surgery, oncology, combustiology) and patient routing preferences. At the second stage of the work, with the involvement of federal experts, the SWOT analysis technology was implemented as a universal method of strategic planning, with the justification of the location and number of MRCs in individual FD of the country, about specific medical organizations where they are based. For an objective (quantitative) assessment of the provision of the Federal District of Russia with the MRC of specialized medical care for children according to the established profiles of activity, we have proposed a calculated indicator the regional contingency coefficient (CRC), representing the ratio of two uniformly calculated values the number of MRCs and regions in a particular Federal District, or the country as a whole. Results. The consolidated position of federal experts regarding the location of the MRC was formulated according to the established profiles of activity about FD and specific medical organizations in the Russian Federation constituent entities. The cattle in the profile of the activity of neonatal surgery was 0.14, and about neurosurgery, thoracic surgery, and oncology, respectively, 0.12, 0.11, and 0.11 for Russia as a whole. The lowest (0.09) cattle in the country characterized the situation with the combustiology profile. In the overwhelming majority (76.0%), the location of the MRC is tied to the administrative centers of the Federal District or cities of federal significance. Among the 50 MRCs of all priority profiles, 43 (86%) were potentially designated by experts based on multidisciplinary pediatric medical organizations. Discussion. The effectiveness of the MRC functioning is due to the organization of medical and evacuation support for children with diseases and injuries. The development of consultative and resuscitation centers in the primary hospital structure is promising. Its functionality, along with remote counseling, treatment, and evacuation activities, includes monitoring the condition of sick and affected children at the place of primary hospitalization. An alternative is a presence on the clinical base of the MRC of a structural unit or a branch of the regional center for emergency medical care and disaster medicine. Conclusion. Overcoming the inequality in the availability and quality of medical care for children in certain FD and regions of Russia is necessary to reorganize the current system of staged medical care. Optimal logistics of medical and evacuation support for specialized patients and injured people include the MRC as a collector for children in need of specialized care, including high-tech medical care, with the implementation of the predominant principle of evacuation of oneself.

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