Features of the organization of coloproctological care to the population taking into account regional indicators of incidence

Abstract

Rationale. The article provides an analysis of the features of the organization of coloproctological care for the population of the Perm Territory, taking into account regional morbidity rates, which made it possible to identify a number of significant shortcomings. There is no connection between the volume of specialized coloproctological care provided and the real need of the population. It was revealed that 32.0 % of coloproctological patients are being treated by doctors of other specialties. In 2018, 47,172 cases of coloproctological diseases were registered, and only 30,900 specialized outpatient appointments were made in the region (11.7 appointments per 1,000 population). More than half of them (57.4 %) were held in Perm.The aim of the study. Determination of the features of the organization of coloproctological care for the population of the Perm Territory, considering the incidence rates.Materials and methods. An analysis was made of the distribution among the adult population of the Perm Territory of pathologies related to the profile of coloproctology according to official statistical reports and the report of the chief specialist of the region for 2018.Results. In 2018, 3.9 sigmoidoscopies per 1,000 population were performed and 1.7 fibrocolonoscopies per 1,000 population, which led to an insufficient level of diagnosis of coloproctological pathologies. At the same time, identified for the period 2004–2018, a significant increase in the incidence of colorectal cancer (by 48.1 %), with an average annual growth rate over 15 years of 7.8 %, which is 3 times higher than the national figure, requires a change in approaches to the organization of coloproctological care, incl. for early diagnosis.Conclusion. Thus, in order to improve the quality of early diagnosis of coloproctological, and especially onco-coloproctological diseases, it is required to optimize the outpatient specialized coloproctological care in the Perm region. It is proposed to reorganize the service with the aim of organizing a primary link on the basis of an outpatient coloproctology center with a daily stay hospital, separate or at the coloproctology department of the City Clinical Hospital.