The Impact of the Supply of Oncologists on Mortality from Neoplasms in the Regions of Russia

Abstract

How does one calculate the ideal number of oncologists for a region? The significance of this study is determined by the differences in these indicators observed across different regions within the Russian Federation. In 2021, the mortality rate from oncological diseases ranged from 54 to 270 per 100,000 people, with the lowest rate in the Republic of Ingushetia and the highest in the Tula Oblast. Furthermore, the level of oncologist availability varies up to fourfold between different regions. The study aims to simulate the effect of the availability of oncologist care on the cancer mortality rates in the Russian Federation's regions, with the intention of determining the ideal number of specialist doctors. The author supposes that there may be an underestimation of the negative impact of physicians on mortality rates due to false positive relationships between the variables under consideration. In addition, the author suggests that there may be diminishing returns from hiring additional physicians as the level of specialist personnel availability increases. The research project is designed to employ a regression analysis using the quasi-experimental instrumental variable method to address reverse causality and omitted variables. Models based on spatial sampling and panel data are employed to derive a function that describes the number of saved lives by means of hiring additional doctors. The results indicate that on average, a 1% increase in the availability of oncologists leads to a reduction in neoplasm mortality of at least 0.4%. At a provision level of 1 oncologist per 100,000 individuals, their marginal contribution to the number of saved lives is no less than 96 per 100,000 people. This contribution reduces by an additional 14 people as the provision level increases by 1 unit. The study's outcomes may assist in ascertaining the ideal quantity of oncologists within the region, and aid in allotting financial resources for hiring medical professionals in diverse specialties or other expenses amid resource constraints.