Modern methods for medical rehabilitation of children with oncology and hematological studies in the Russian Federation: Regional practices and development vector

Introduction: Medical rehabilitation of pediatric patients with oncological and hematological diseases is a complex, interdisciplinary task. The uneven distribution of rehabilitation resources across regions necessitates the development of unified approaches that take into account regional specificities.
Materials and Methods: Analysis of the regulatory framework; a multicenter study (12 regions of the Russian Federation) that included a survey of healthcare workers (n=215), an analysis of individual rehabilitation programs (n=149), and an assessment of the effectiveness of rehabilitation measures and the infrastructure of rehabilitation centers.
Results and Discussion: Three main models of rehabilitation organization were identified:
- Specialized departments in oncology centers (42%)
- General rehabilitation centers (35%)
- Outpatient clinics (23%).
Key Deficiencies Were Identified:
- Lack of multidisciplinary teams (68% of institutions)
- Limited use of evidence-based methods (41%)
- Lack of continuity between treatment stages (57%)
The main drawback is the lack of centralized regional routing schemes for patients requiring rehabilitation.
Discussion: The findings reveal significant heterogeneity in the organization and delivery of rehabilitation services for children with oncohematological diseases across the Russian Federation. The identified deficits highlight the challenges in providing comprehensive and evidence-based rehabilitation care.
Conclusion: The proposed model for organizing rehabilitation care allows for:
- Unifying approaches based on regional capabilities
- Ensuring continuity between stages of care
- Improving the effectiveness of rehabilitation measures
Promising Areas of Development:
- Development of federal clinical guidelines
- Active implementation of telemedicine consultations
- Active patient routing (if there are no rehabilitation centers in the region)

Philip Nikolaevich Kostin is the Deputy Director of the Department for Planning and Strategic Development of the Pediatric Oncology and Hematology Service. He has published more than 25 articles in renowned journals.