OBJECTIVE
To develop proposals for improvement of the routing effectiveness of patients with malignant neoplasms.
MATERIAL AND METHODS
The results of the questionnaire of the chief freelance specialists oncologists of executive government bodies of the constituent entities of the Russian Federation in the field of health care of citizens and other persons with organizational and methodical work experience on the «oncology» profile were analyzed and summarized. The expert was asked to estimate the minimum and maximum number of waiting days for each component of the routing stage in days, as well as to identify factors in arbitrary form that can increase and complicate the transit time of stage by patient. In total, 26 responses from 19 constituent entities of the Russian Federation were received.
RESULTS
Issue of an appointment card to oncologist from the moment of establishing suspicion of oncological disease took on average at least from 1.6±1.4 to 5.4±3.4 days (W=0.96, p<0.001, α=0.55). Total time for the diagnostic stage (α=0.91): from initial consultation by an oncologist to the creation of report on the case of oncological disease was from 9 to 46 days. The treatment phase from getting an appointment card to oncologist to conducting consultation in the national medical research center took from 13 to 46 days (α=0.82). The time for getting an appointment card and hospitalization for medical rehabilitation was from 6 to 21.5 days (α=0.59). The time taken to receive an appointment card and hospitalization for palliative care was from 2.5 to 9.3 days (α=0.73). The main proposals for improvement of routing are to ameliorate the staffing and basic infrastructure of medical facilities, to create a «green corridor» for the diagnosis of oncological diseases and to increase the bed capacity.
CONCLUSION
The conducted study allowed to determine, based on an expert survey, the timing of health care delivery for patients with oncological diseases as well as to identify the main directions for improvement of the routing of such patients.