Репозиторий Университета

© 2018 National Academy of Pediatric Science and Innovation. All rights reserved. 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 year is 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.

© 2018 Paediatrician Publishers, LLC. All rights reserved. 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.

© 2018 Onkopediatria. All rights reserved. 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.

© 2018 Paediatrician Publishers, LLC. All rights reserved. Background: Moscow and St. Petersburg are cities of federal significance with the largest number of children and consequently a large number of primary patients identified annually. Objective: Our aim was to analyze the main indicators characterizing the delivery of medical care for children with cancer in cities of federal significance. Methods: The operative reports for 2013–2017 of the Department of Health of Moscow, the Ministry of Health of the Moscow Region, the Health Committee of the Government of St. Petersburg, and the Health Committee of the Leningrad Region were analyzed. Results. In 2013–2017 in the Russian Federation, 18 090 primary patients were identified, 2734 (15.1%) of them in the analyzed subjects: in Moscow — 1315 (7.3%), in the Moscow Region — 492 (2.7%), in St. Petersburg — 697 (3.9%), in the Leningrad Region — 230 (1.3%). For 5 years, the number of primary patients increased in Moscow by 18.1%, in St. Petersburg — by 36%, in the Leningrad Region — by 2.5%. In the Moscow Region, the number of primary patients decreased by 2.3%. The incidence in Moscow increased by 5.3% (from 11.3 per 100 000 of children aged 0–17 in 2013 to 11.9 in 2017), in St. Petersburg — by 18.1% (from 14.9 in 2013 to 17.6 in 2017). The incidence in the Moscow Region fell by 20% (from 11.8 in 2013 to 9.4 in 2017), in the Leningrad Region by 4.9% (from 14.4 in 2013 to 13.7 in 2017). Mortality in 2016–2017 in Moscow decreased by 37.5% (from 6.4 per 100 thousand children’s population 0–17 years to 4), in the Moscow Region — by 50% (from 2 to 1), in St. Petersburg increased by 50% (from 2 to 3), in the Leningrad Region — by 12.5% (from 2.4 to 2.7). The one-year mortality rate in Moscow increased by 3.7% (from 8.3% in 2016 to 12% in 2017), in the Moscow Region — by 3.5% (from 5.4 to 8.9% %), in St. Petersburg — by 3.9% (from 2.5 to 6.4%). In the Leningrad Region, the one-year mortality rate decreased from 6.5% in 2016 to 0 in 2017. The number of pediatric oncological beds did not change in the Moscow Region (0.4 per 10,000 children aged 0–17 years), St. Petersburg (0.9), and the Leningrad Region (0). In Moscow and St. Petersburg patients were not identified actively in 2016–2017; in the Moscow Region, their percentage decreased from 34.2 to 7.3, in the Leningrad Region — from 8.7 to 0. In Moscow, the number of pediatric oncological beds increased by 50% (from 0.6 to 0.9). The number of oncologists increased in the Moscow Region from 0.009 per 10 000 children aged 0–17 years to 0.06 (66.7%), in St. Petersburg from 0.09 to 0.12 (+33.3%), in the Leningrad Region — from 0 to 0.03. In Moscow, the number of pediatric oncologists decreased from 0.13 to 0.11 (-15.3%). Conclusion: Defects of statistical data were revealed. Patients were not identified during routine preventive examinations which indicate a low oncologic alertness of district pediatric physicians. Delivery of medical care for children with cancer and the statistical data accumulation procedures should be improved.