Analysis of the causes of public dissatisfaction with the provision of high-tech medical care to patients with malignant neoplasms in the Moscow region

2020 ◽  
pp. 28-36
Author(s):  
E.Yu Ogneva ◽  
◽  
E. V. Gameeva ◽  
2018 ◽  
Vol 5 (4) ◽  
pp. 106-117
Author(s):  
E. Yu. Ogneva ◽  
A. N. Gurov ◽  
M. V. Pirogov ◽  
E. V. Gameeva ◽  
O. Yu. Aleksandrova

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.


2018 ◽  
Vol 5 (3) ◽  
pp. 145-154
Author(s):  
M. Yu. Rykov ◽  
I. N. Inozemtsev ◽  
S. A. Kolomenskaya

Background.Analysis of medical care delivery for children with cancer in armed conflict is highly important because the high-tech treatment in this context is extraordinary difficult and challenging task. Objective. Our aim was to analyze the morbidity and mortality rates in children with malignant tumors, to assess the pediatric patient capacity and medical service density in the Donetsk People’s Republic.Methods.The ecological study was conducted where the units of analysis were represented by the aggregated data of the Republican Cancer Registry on the number of primary and secondary patients with malignant and benign tumors, the deceased patients in the DNR in 2014–2017, pediatric patient capacity, and medical service density.Results.The number of pediatric patient capacity for children with cancer was 10 (0.27 per 10,000 children aged 0–17), pediatric patient capacity for children with hematological disorders — 40 (1.37 per 10,000 children aged 0–17). The treatment of children with cancer was performed by 5 healthcare providers: 1 pediatric oncologist (0.02 per 10,000 children aged 0–17), 3 hematologists (0.08 per 10,000 pediatric population aged 0–17), and 1 practitioner who did not have a specialist certificate in oncology. Morbidity rate for malignant neoplasms from 2014 to 2017 decreased by 25% (in 2014 — 9.6 per 10,000 children aged 0–17; in 2017 — 7.2). In the morbidity structure, the incidence proportion of hemoblastoses was 68.4%, brain tumors — 2.6%, other solid tumors — 29%. The death rate due to malignant neoplasms decreased by 37% (in 2014 — 2.7; in 2017 — 1.7).Conclusion.Low levels of the incidence rate and pattern of morbidity indicate defects in the identification and recording of patients. This explains the performance of the bed: low average bed occupancy per year and low turnover. For a reliable analysis of mortality statistical data is not available: in 2014–2015 only the number of in-hospital deceased patients is presented. Limited data is due to the lack of reliable patient catamnesis which is explained by the high rate of population migration. 


2021 ◽  
Vol 2 (1) ◽  
pp. 50-56
Author(s):  
Ekaterina V. Markarova ◽  
◽  
Lali M. Kogoniya ◽  
Vladimir L. Astashov ◽  
◽  
...  

Aim. The purpose of the study was to analyze the incidence of breast cancer (breast cancer) in the Moscow Region (MO) for a period of time from 2015 to 2018. Materials and methods. The data of the territorial Cancer Register of the MO are used. Results. During the observation period of 4 years, 14 024 new cases of breast cancer were diagnosed on the territory of the Moscow Region. Analysis of data on morbidity and mortality from malignant neoplasms is of great importance for determining the needs of the population in specialized medical care.


2020 ◽  
pp. 166-173
Author(s):  
L. M. Kogoniya ◽  
V. I. Astashov ◽  
S. N. Minakov

Introduction. Breast cancer is a serious medical and social challenge and the statistics around the world look daunting.Relevance. The incidence of breast cancer is increasing in most countries and this may be due to a number of reasons. First of all, it should be noted the improvement of diagnostic methods, in particular, mass mammographic screening, which allows detecting neoplasms at early stages, before the onset of clinical symptoms. As for mortality rates, in recent years, world statistics show a downward trend in rates.Goal. To analyze the incidence and mortality rates of breast cancer (BC) in the Moscow Region (MO) for the period from 2011 to 2018. The study of indicators in one of the regions of Russia – MO – is of great importance for determining and predicting the true needs of the population in specialized medical care.The purpose of the study was to analyze the incidence of breast cancer (breast cancer) in the Moscow Region (MO) for a period of time from 2011 to 2018.Materials and methods. Some data of the territorial cancer registry of the Ministry of Defense of the Russian Federation on the diagnosis and treatment of patients with breast cancer were used, which will make it possible to determine the needs of this cohort of patients in specialized care.Results. From 2011 to 2018, 26755 new cases of breast cancer were diagnosed in the Moscow Region. The analysis of the comparative stratification in breast cancer in the medical district made it possible to obtain statistically significant differences indicating an increase in the incidence in the period from 2015–2018 in comparison with the period of 2011–2014. The presented data also indicate a trend towards a decrease in the one-year mortality rate over 8 years: from 6.33% in 2011 to 5.32% in 2018. For the period from 2011 to 2018 (8 years) there is an increase in the number of patients with breast cancer who have been in the medical center under dispensary supervision for 5 years or more.Conclusions. Analysis of the data obtained on the indicators of morbidity and mortality from malignant neoplasms is of great importance for determining the needs of the population in specialized medical care.


2020 ◽  
Vol 22 (1) ◽  
pp. 146-151
Author(s):  
N S Romanenkov ◽  
K N Movchan ◽  
V V Hizha ◽  
A V Zharkov ◽  
U M Morozov ◽  
...  

The 5-year survival rates for women with breast cancer are steadily increasing. The number of cases of mastectomy for breast cancer is not reduced annually. In this regard, the analysis of epidemiological data on the observations of breast cancer in women in Russia seems to be an urgent activity in terms of predicting measures to optimize the volume of the recovery component of providing medical care to patients who have undergone mastectomy. It was established that in2017 in St. Petersburg the incidence rate of breast cancer reached 60,1100/. The parameter of the prevalence of malignant0000neoplasms of the mammary glands for the analyzed period exceeds the similar all-Russian by 19,3%. The frequency of casesof active detection of breast cancer in 2011-2018. increased 7,2 times. In the same period, the number of working-age urbanwomen diagnosed with breast cancer increased by 16,6%. The proportion of cases of verification of breast cancer of the I - IIstage of the tumor process in 2011-2018 increased by 1,2 times, reaching 72,2% in 2018. From 2011 to 2018, the growth of5-year survival of patients with breast cancer in St. Petersburg reached 4,9%, amounting to 63,4 in 2018% The parameterof annual mortality in breast cancer in 2011-2018 decreased by 30,6%. The performance indicators of the St. PetersburgOncology Service for the treatment of patients with breast cancer are comparable with similar parameters in Moscow clinicsand medical organizations in Russia as a whole. The increase in potential needs for prosthetics of the mammary glands dueto the increase in the number of patients with cancer who underwent mastectomy, in the future will necessitate the expansionof the high-tech types of medical care provided to patients suffering from malignant neoplasms of the mammary glands.


2020 ◽  
pp. 44-47
Author(s):  
A. A. Alekseev ◽  
A. E. Bobrovnikov ◽  
V. V. Bogdanov

In order to include innovative technologies in clinical recommendations, confirmation of their clinical effectiveness in comprehensive treatment of burned patients is necessary. 1,696 case histories of patients with burns were audited, which are divided into two groups depending on peculiarities of treatment. The use of innovative treatment technologies for burned patients has reduced the incidence of burn disease complications and mortality. Introduction of innovative technologies in treating burned patients into broad clinical practice improves results of provision of specialized, high-tech medical care for victims of burns.


Author(s):  
Arkady Nikolaevich Daykhes ◽  
Vladimir Anatolievich Reshetnikov ◽  
Olga Aleksandrovna Manerova ◽  
Ilya Aleksandrovich Mikhailov

Aim of the study. Analysis of medical tourism’s organizational features based on the example of the large medical organizations in the United Kingdom, South Korea, Italy and China. Materials and methods. The data were collected by the authors by interviewing the heads of medical organizations and their deputies in the United Kingdom, South Korea, Italy and China (3–4 respondents per medical organization) using the developed questionnaire to identify the main mechanisms and tools for organizing the export of medical services. SWOT-analysis (Strengths; Weaknesses; Opportunities; Threats) was performed in order to comprehensively evaluate the received information. Results. Along with weaknesses and threats that slow down the development of medical services exports, strengths (internal factors) and opportunities ( external factors) that contribute to the development of medical tourism were also identified: the widespread popularity of the brand of medical organizations abroad which is associated with the provision of premium medical services; versatility and ability to conduct high-tech surgical operations; the presence of a separate premium class building and an international department for working with foreign patients and promoting a medical organization in the world market; well-established business relationships with assistance companies; foreign medical personnel who speak foreign languages and possess necessary skills to treat foreign patients; developed electronic medical care system; developed system of quality control of medical care; the presence of branches in other countries; the presence of a medical visa in the system of legislation; established cooperation with many countries at the embassy level; state licensing and accreditation for the provision of medical services to foreign citzens; the availability of a state website on the provision of medical assistance to foreign citizens; the possibility of the age of value added tax. Conclusion. We identified main patterns in the organization of export of medical services that can be applied to develop this direction in medical organizations of the Russian Federation during the analysis the strengths and weaknesses of four large medical organizations abroad, as well as external factors that affect the work of these medical organizations.


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