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3 . 2022

The impact of the reduction in primary health care during the COVID-19 pandemic on the morbidity and mortality from malignant neoplasms of the adult population in the subjects of the Volga Federal District

Abstract

In the structure of mortality and disability in Russia, oncological diseases occupy leading positions. An important link in the diagnosis is primary health care, which contributes to the detection of cancer in the early stages. In 2020, due to the COVID-19 pandemic, visits to primary care were reduced. The authors studied the impact of the changed volumes of medical care on the incidence and mortality rates of the population of the Russian Federation and the Volga Federal District (VFD) from malignant neoplasms (MNT).

Material and methods. The object of the study was the nature of the relationship between the incidence of cancer and death from cancer, as well as their relationship with some indicators of the oncological service, human resources for health care and performance indicators of primary health care.

The subject of the study is the level of primary incidence of malignant neoplasms in the adult population, the mortality rate from malignant neoplasms, the proportion of early detection of malignant neoplasms, one-year mortality and five-year survival rates, the availability of district physicians and oncologists, the number of visits to the outpatient clinic link.

Units of observation: primary incidence rate of malignant neoplasms in the adult population per 100 thousand population, mortality rate from CVD per 100 thousand population, per cent of detection of malignant neoplasms at stages I–II, III–IV of the disease, one-year mortality in per cent, five-year survival rate in per cent, security of the population by district general practitioners, oncologists per 10 thousand population, the number of visits to the outpatient clinic unit per 1 inhabitant in total, including for diseases and for preventive visits.

The work used monitoring data of the above indicators on average for the Russian Federation, the Volga Federal District and in the context of each region of the Volga Federal District from official statistical reporting forms in the pre-pandemic period of 2015–2019 in comparison with the period of the pandemic of a new coronavirus infection COVID-19 in 2020. Statistical data processing was performed using methods for assessing the statistical significance of differences in average values, analysis of time series. Data processing was carried out using Microsoft Office Excel (2010) and Statistica 6.0.

Results. The study revealed that during the COVID-19 pandemic in 2020, the primary incidence of malignant neoplasms in the adult population in the Russian Federation, the Volga Federal District and the regions of the Volga Federal District decreased compared to 2019, and is accompanied by a shift in the detection of tumors from I–II stages to III–IV stages. The mortality rate from malignant neoplasms in the specified period has not changed. During the pandemic, a decrease in the number of visits to primary health care in the Russian Federation by 18% was revealed, including for diseases – by 15%, for preventive visits – by 23%; in general, in the Volga Federal District, the indicators amounted to 17, respectively, 13 and 21%. A similar pattern was revealed in all regions of the Volga Federal District. At the same time, a statistically significant inverse relationship was observed between the number of visits for diseases and the mortality rate from malignant neoplasms (r=-0.38, p<0.05).

Conclusion. As a result of the study, it was revealed that a decrease in the volume of primary health care leads not only to a decrease in the rates of diagnosis of malignant neoplasms in the early stages, but also contributes to an increase in mortality rates from malignant neoplasms. In order to increase the volume of primary health care for patients with suspected cancer during a pandemic, outpatient oncological care centers can be used, performing the function of interdistrict oncological centers of the second level, where the risk of oncological patients crossing with other groups of patients is minimized, including with suspected coronavirus infection.

Keywords:malignant neoplasms; primary morbidity; mortality; Volga Federal District; COVID-19 pandemic

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

Contribution. Development of the concept, formation of the idea, formulation of key goals and objectives, analysis and interpretation of the data obtained, approval of the final version of the article – Pereslegina I.A.; preparation and editing of the text, selection of statistical material – Sivodedova N.A.; approval of the final version of the article, drafting of the manuscript – Karyakin N.N.; statistical analysis, application of statistical, mathematical, computational or other formal methods for the analysis and synthesis of research data – Bolshev A.S.; conducting research, preparing statistical data for analysis and interpretation – Varenova L.E.

For citation: Pereslegina I.A., Sivоdedova N.A., Karyakin N.N., Bolshev A.S., Varenova L.E. The impact of the reduction in primary health care during the COVID-19 pandemic on the morbidity and mortality from malignant neoplasms of the adult population in the subjects of the Volga Federal District. ORGZDRAV: novosti, mneniya, obuchenie. Vestnik VSHOUZ [HEALTHCARE MANAGEMENT: News, Views, Education. Bulletin of VSHOUZ]. 2022; 8 (3): 10–21. DOI: https://doi.org/10.33029/2411-8621-2022-8-3-10-21 (in Russian)



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CHIEF EDITOR
CHIEF EDITOR
Guzel E. Ulumbekova
MD, MBA from Harvard University (Boston, USA), Head of the Graduate School of Healthcare Organization and Management (VSHOUZ)

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