Workforce evaluation in the field of radiation oncology: National data from a limited-resource setting.

Abstract

e13576 Background: The workforce shortage in the field of radiation oncology is a critical challenge in developing countries. This study's main objective was to evaluate the workload of radiation oncologists (RO) in Armenia. Methods: In this cross-sectional study, the adapted questionnaire from Gunasekera et al. (2021) survey was used. The study setting was the only two RO centers operating in Armenia (public and private). For data collection purposes, census sampling was done and self-administered questionnaires were distributed. The data collection time frame was 15-25 July 2023. Descriptive statistics was done to analyze and present data through portions. Results: In total, data on 16 ROs and residents was collected. The ratio of ROs per million population was 6 in 2023, in Armenia. Primary consultations in median lasted 25 minutes (range: 10-40 mins). Similarly, consults of the patients on active treatment lasted in median of 12.5 minutes (min-60 mins). The median duration of follow-up oncology care consults was 7.5 minutes per day (range: 10- 40 mins). In terms of clinic hours, physicians in public settings reported spending a median of 50 hours per week. According to the respondents, on average radiation therapy specialists allocated 50% of their working time to providing direct patient care, 35% to fulfilling administrative responsibilities, 5% to educational and teaching endeavors, and 10% to conducting scientific research. The median radiation therapy delay was 1 week. Namely, treatment delay in the non-metastatic setting was 1․19, and in the metastatic setting 1 week. By the ROs, the most common barriers to delivering cancer care were treatment high cost (68%, n=11), lack of access to imaging (18.7%, n=3) and pathological (18.7%, n=3) diagnostic procedures, and lack of physicians' time to dedicate to patients (31%, n=5). Conclusions: Our study offers some insight into the radiation oncology workload in Armenia. From this research, we conclude that Armenian healthcare is understaffed in terms of radiation oncologists and medical physicists compared to other upper-middle-income and high-income income countries. Moreover, the median daily workload of the ROs exceeds the upper limit of the amount of consults suggested by the international societies. Hence, further research is required for a detailed evaluation of the RO workforce and specific intervention development that will be able to address this issue in Armenia and other resource-limited settings.