Assessment of the organization of medical rehabilitation of children with oncological and hematological diseases in the subjects of the Russian Federation

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Abstract

Background. Medical rehabilitation of children who have suffered from oncological and hematological diseases is a critically important stage for improving the long-term quality of life. However, in the regions of the Russian Federation, access to high quality, comprehensive and continuous rehabilitation care remains uneven, and existing organizational models are characterized by fragmentation and systemic deficits, which creates a significant gap in providing care to this category of patients.

Aims — to conduct a comprehensive analysis of the current state, identify key problems and needs in organizing rehabilitation care for children with oncological and hematological diseases at the regional level, based on expert assessment from the heads and specialists of relevant medical organizations.

Methods. In 2026, a single-point cross-sectional study was conducted using the structured questionnaire method. The object of the study was medical organizations of the constituent entities of the Russian Federation that provide care for children with oncohematological diseases (n = 65). The questionnaire assessed infrastructure capacity (departments, personnel, and equipment), applied models and stages of rehabilitation, as well as organizational and financial difficulties. The primary endpoint was a comprehensive assessment of the state of the rehabilitation care system at the regional level, analyzed using descriptive statistics and content analysis of qualitative data.

Results. The study involved 65 medical organizations from various regions of the Russian Federation. The results revealed systemic shortcomings. Unified rehabilitation programs are absent in 89.2% of regions, and the decision to initiate rehabilitation is predominantly (94%) made post hoc by the treating physician. Accessibility is limited to basic types of care; modern methods (neurocognitive rehabilitation, motor rehabilitation) are available in less than 15% of institutions, and home-based rehabilitation is not provided. The shortage of specialized professionals (rehabilitation specialists, neuropsychologists, physiotherapists) is assessed as critical, and regular professional development training is absent in 83% of cases. Funding is deemed insufficient for long-term multidisciplinary care in 98% of responses. Interagency cooperation with social and educational institutions is undeveloped. The care model is fragmented and heavily reliant on local resources and charitable contributions.

Conclusions. The study objectively confirmed the fragmentation and resource insufficiency of the medical rehabilitation system in pediatric oncology and hematology at the regional level. The obtained data form an evidence base for the immediate development of federal standards, implementation of telemedicine solutions, and centralization of methodological guidance to ensure equal access to quality care across the entire territory of the country.

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About the authors

Filipp N. Kostin

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology

Author for correspondence.
Email: filipp.kostin@dgoi.ru
ORCID iD: 0000-0001-6438-1293
SPIN-code: 7489-9689

Deputy Director of the Department for Planning and Strategic Development of the Pediatric Oncology and Hematology Service

Russian Federation, Moscow

Irina N. Novoselova

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology; Clinical and Research Institute of Emergency Pediatric Surgery and Trauma — Roshal’s Clinic; Russian Medical Academy of Continuous Professional Education

Email: irina.novoselova@dgoi.ru
ORCID iD: 0000-0003-2258-2913
SPIN-code: 1406-1334

MD, PhD, Assistant Professor, Deputy Director

Russian Federation, Moscow; Moscow; Moscow

Alexander F. Karelin

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology

Email: Alexandr.Karelin@dgoi.ru
ORCID iD: 0000-0003-4664-5616

MD, PhD, Director of the “Russian Field” Research Center

Russian Federation, Moscow

Anna V. Petrichenko

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology; Russian Medical Academy of Continuous Professional Education; Pirogov Russian National Research Medical University (Pirogov Medical University)

Email: anna.petrichenko@dgoi.ru
ORCID iD: 0000-0001-6876-7898
SPIN-code: 6906-6292

MD, PhD, Deputy Director of the “Russian Field” Research Center

Russian Federation, Moscow; Moscow; Moscow

Sergey A. Dukoyan

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology

Email: sergey.dukoyan@dgoi.ru
ORCID iD: 0009-0006-5705-9590
SPIN-code: 4794-6646

MD, PhD, Director of the Department for Extra-budgetary Activities

Russian Federation, Moscow

Andrey A. Puchkov

Regional Children’s Clinical Hospital, Stavropol

Email: kdkb@skkdkb.ru
ORCID iD: 0009-0007-1728-4467

Chief Medical Officer

Russian Federation, Stavropol

Nikolay S. Grachev

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology; I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: nikolay.grachev@dgoi.ru
ORCID iD: 0000-0002-4451-3233
SPIN-code: 2836-2349

MD, PhD, Professor

Russian Federation, Moscow; Moscow

References

  1. Румянцев А.Г., Володин Н.Н., Касаткин В.Н., и др. Междисциплинарная комплексная реабилитация детей с гематологическими и онкологическими заболеваниями // Гематология. Трансфузиология. Восточная Европа. — 2015. — № 3 (03). — С. 15–39. [Rumyancev A, Volodin N, Kasatkin V. Interdisciplinary Complex Rehabilitation of Children with Hematological and Oncological Diseases. Hematology. Transfusiology. Eastern Europe. 2015;3(03):15–39. (In Russ.)]
  2. Практическое руководство по детским болезням / под общ. ред. В.Ф. Коколиной, А.Г. Румянцева. Т. 10: Восстановительное лечение в педиатрии / под ред. Б.А. Поляева, О.А. Лайшевой. — М.: Медпрактика-М, 2008. — 492 с. [Prakticheskoe rukovodstvo po detskim boleznyam / pod obshch. red. VF Kokolinoj, AG Rumyanceva. T. 10: Vosstanovitel’noe lechenie v pediatrii / pod red. BA Polyaeva, OA Lajshevoj. Moscow: Medpraktika-M; 2008. 492 s. (In Russ.)]
  3. Бауер Т. Психическое развитие младенца: пер. с англ. / под общ. ред. А.В. Запорожца, Б.М. Величковского. — М.: Прогресс, 1979. [Bauer T. Psihicheskoe razvitie mladenca: per. s angl. / pod obshch. red. AV Zaporozhca, BM Velichkovskogo. Moscow: Progress; 1979. (In Russ.)]
  4. Бернштейн Н.А. Физиология движений и активность / под ред. О.Г. Газенко. — М.: Наука, 1990. — 499 c. [Bernshtejn NA. Fiziologiya dvizhenij i aktivnost’ / pod red. OG Gazenko. Moscow: Nauka; 1990. 499 s. (In Russ.)]
  5. Открыт прием пациентов в ЛРНЦ «Русское поле» // Российский журнал детской гематологии и онкологии (РЖДГиО). — 2014. — № 2. — С. 9–12. [The “Russkoe Pole” (Russian Field) Therapy and Rehabilitation Center opens the reception of patients. Russian Journal of Pediatric Hematology and Oncology. 2014;2:9–12. (In Russ.)]
  6. Володин Н.Н., Касаткин В.Н., Цейтлин Г.Я., и др. Стратегия медико-психолого-социальной реабилитации детей с гематологическими и онкологическими заболеваниями // Онкогематология. — 2015. — Т. 10. — № 1. — C. 7–15. [Volodin NN, Kasatkin VN, Tseitlin GYa, et al. Strategy of Medical, Psychological and Social Rehabilitation for Children with Haematological and Oncological Diseases. Oncohematology. 2015;10(1):7–15. (In Russ.)] doi: https://doi.org/10.17650/1818-8346-2015-1-7-15
  7. Данилова Н.В. Проблемы оказания специализированной (реабилитационной) помощи в медицинских организациях // Менеджер здравоохранения. — 2014. — № 10. — С. 33–39. [Danilova NV. Problems with Providing Specialized (Rehabilitation) Aid in Medical Organizations. Health Care Manager. 2014;10:33–39. (In Russ.)]
  8. Савченко В.В., Маяцкая Н.К., Гевандова М.Г. Проблемы оказания медико-социальной и реабилитационной помощи детям-инвалидам // Медицинский вестник Северного Кавказа. — 2016. — Т. 11. — № 1. — С. 117–118. [Savchenko VV, Mayatskaya NК, Gevandova MG. The problems of medico-social and rehabilitation services to children with disabilities. Medical Bulletin of the North Caucasus. 2016;11(1):117–118. (In Russ.)]
  9. Евстропова С.В. Проблематизация межведомственного взаимодействия в системе медико-социальной помощи инвалидам // Миссия конфессий. — 2022. — Т. 11. — Ч. 6. — № 63. — С. 62–66. [Evstropova SV. Problematization of interdepartmental interaction in the system of medical and social assistance to the disabled. Mission confession. 2022;11(6(63)):62–66. (In Russ.)]
  10. Радченко Т.Е., Абрамова С.Б. Совершенствование межведомственного взаимодействия в программе комплексной реабилитации инвалидов // Вопросы управления. — 2018. — № 1 (50). — С. 138–145. [Radchenko TE, Abramova SB. Development of Interdepartmental Cooperation in Complex Rehabilitation Program for People with Disabilities. Management Issues. 2018;1(50):138–145. (In Russ.)]
  11. Иванова Г.Е. Медицинская реабилитация в России. Перспективы развития // Consilium Medicum. — 2016. — № 2.1. — С. 9–13. [Ivanova GE. Medical Rehabilitation in Russia. Development prospects. Consilium Medicum. 2016;2.1:9–13. (In Russ.)]
  12. Иванова Г.Е., Аронов Д.М., Белкин А.А. Пилотный проект «Развитие системы медицинской реабилитации в РФ» // Вестник восстановительной медицины. — 2016. — № 2 (72). — С. 2–6. [Ivanova GE, Melnikova EV, Shmonin AA, et al. Pilot Project “Development OF THE Medical Rehabilitation System in Russian Federation (Dome)”: Preliminary Results of Implementation in the First and Second Stages. Bulletin of Rehabilitation Medicine. 2016;2(72):2–6. (In Russ.)]
  13. Аронов Д.М., Бубнова М.Г., Бойцов С.А. Организационные вопросы кардиореабилитационной службы в России. Результаты пилотного проекта «Развитие системы реабилитации больных сердечно-сосудистыми заболеваниями в лечебных учреждениях субъектов Российской Федерации» // Кардиоваскулярная терапия и профилактика. — 2016. — Т. 15. — № 6. — С. 4–12. [Aronov DM, Bubnova MG, Boytsov SA. Organizational issues of cardiorehabilitation service in Russia. The results of Pilot project “Development of rehabilitation system of cardiovascular patients in medical institutions of Russian Federation entities”. Cardiovascular Therapy and Prevention. 2016;15(6):4–12. (In Russ.)]
  14. Ишутин Д.В., Фирсов С.А., Сименюра В.В. К вопросу оценки состояния и перспектив применения принципов биомеханики движений в разработке импортозамещающих технологий медицинской реабилитации // Вестник восстановительной медицины. — 2017. — № 2 (78). — С. 36–43. [Ivanova GE, Ishutin DV, Gertsik YG. On Assessment of Status and Prospects of Movements Biomechanics Principles Application in Development of Import-Substituting Products and Technologies for Medical Rehabilitation. Bulletin of Rehabilitation Medicine. 2017;2(78):36–43. (In Russ.)]
  15. Иванова Г.Е., Герцик Ю.Г., Омельченко И.Н. Перспективы развития медицинской реабилитации в России, как составной части крупномасштабной системы здравоохранения // Управление развитием крупномасштабных систем (MLSD’2019): труды Двенадцатой международной конференции (Москва, 1–3 октября 2019 г.) / под общ. ред. С.Н. Васильева, А.Д. Цвиркуна. — М.: ИПУ РАН, 2019. — С. 1137–1147. [Ivanova GE, Gercik YuG, Omel’chenko IN. Perspektivy razvitiya medicinskoj reabilitacii v Rossii, kak sostavnoj chasti krupnomasshtabnoj sistemy zdravoohraneniya. Upravlenie razvitiem krupnomasshtabnyh sistem (MLSD’2019): trudy Dvenadcatoj mezhdunarodnoj konferencii (Moskva, 1–3 oktyabrya 2019 g.) / pod obshch. red. S.N. Vasil’eva, A.D. Cvirkuna. Moscow: IPU RAN; 2019. S. 1137–1147. (In Russ.)]

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