Implementation of hematological day hospitals in the federal districts and regions of the Russian Federation

Introduction. Over the period from 2019 to 2023, there has been an increase in the prevalence of hematological diseases (malignant and non- malignant) (HemD). This situation once again highlights the need to ensure the availability of accessible specialized medical care (SMC) and its continuity at all stages, which is possible in a hematological day hospital (HDH).

Aim: To assess the availability of HDH in the public healthcare sector of the Russian Federation (RF), its Federal Districts (FD), and constituent entities.

Materials and methods. Information from the reporting industry forms of federal statistical observation No. 14-DS (FFSN No. 14-DS) for 2019–2023 and data from territorial compulsory health insurance funds for 85 constituent entities of the Russian Federation were analyzed.

Results. By 2023, hematological services were organized in 85 of the 89 constituent entities of the RF, while HDH were only available in 63 (74%). HDH operate both in 24-hour hospitals (CH) and in outpatient settings. The number of hematological beds for adults increased by 21.7% from 2019 to 2023, from 533 to 636 beds. From 2019 to 2023, the provision of adult population with HDH in the Russian Federation increased by 28% from 0.046 to 0.059 per 10,000 adults respectively. A positive trend in the analyzed indicators was observed in all federal districts, with the exception of the Far Eastern federal district, where there was a sharp decrease in the provision of HDH from 0.06 to 0.03 due to a change in a change in bed profile to oncology. The average increase in the number of hospitalizations in the HDH per 10,000 adult populations between 2019 and 2023 was 332% (from 2.9 to 12.53). The average duration of treatment in the HDH in 2019 and 2023 in the Russian Federation decreased by 16%, from 6.9 to 5.8 days, respectively. In 2023 SMC in HDH was provided in 55,930 cases in the Russian Federation, of which 26,117 (47%) were at the outpatient stage. To support HDH operations, physicians from previously established hematology departments were involved. For the financial support of HDH, the formulation of the clinical-statistical group ds19.033 “Hospitalization for diagnostic purposes with molecular genetic and/or immunohistochemical testing or immunophenotyping” in the State Guarantees Program was amended, enabling high-tech diagnostics of hematological diseases.

Conclusion. HDH are insufficiently integrated into the healthcare system of the RF and are absent in 22 regions. In the constituent entities of the RF, it is necessary to continue organizing HDH, which are an economically viable form of providing emergency medical care to the adult population, allowing for the effective examination and treatment of hematological patients while maintaining their usual quality of life.

Acknowledgment. The authors express their gratitude to the heads of the hematology service in the regions of the RF, as well as to the staff of the FSBI Russian Research Institute of Health of the Ministry of Health of the RF for the materials provided and for their assistance in selecting information materials.

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