Routing in breast cancer as a factor in timely provision of medical care

An important task of the regional healthcare system is to ensure the earliest possible time for the start of treatment for oncological diseases. According to the regulatory documents in the Russian Federation, the key importance in solving this problem is assigned to the routing system for cancer patients in the region. Effective routing approaches should lead to a reduction in patients’ waiting time to start treatment. Objective. To conduct a comparative assessment of changes in the timing of the start of antitumor treatment before and after the formation of a regional routing system for patients with breast cancer (BC) using the example of one of the regions of the Russian Federation — the Yamalo-Nenets Autonomous District (YNAD). Material and methods. According to the regional information systems of YNAD, the timing of the start of treatment for patients with BC in the periods 2015—2016 and 2018—2019 was studied. The data obtained during the study were processed in Excel (Microsoft, USA), IBM SPSS Statistics ver. 20 (IBM, USA) software packages. Results. Taking into account the specifics of the medical and transport infrastructure of YNAD, cancer routing was changing. The influence of the proposed approaches on the timing of the start of antitumor treatment for BC in the period 2015—2016 and 2018—2019 was studied. A reduction in the start time of treatment from 32.9 days before the change of the routing system to 14.9 days after the reorganization was shown (p<0.001). The differences in the assessment are statistically significant (p<0.001). Conclusion. The set of proposed solutions can serve as the basis for organizational approaches for regional medical institutions providing specialized oncological care for BC.