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

Abstract

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.