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

Abstract

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.