Regional disparities in staffing and the qualification index of gynecologic oncologists in Ukraine: statistical portrait and human resource development scenarios (2015–2020, 2022–2024)

Abstract

In press

Background. Cervical cancer remains a leading cause of mortality among women of reproductive age in Ukraine. The effectiveness of its prevention depends on the availability and qualifications of gynecologic oncologists. A comprehensive analysis of the staffing of Ukraine's gynecologic oncology service had not been previously conducted.

Aim. To analyze regional disparities and the qualification structure of oncogynecologists in Ukraine for the periods 2015–2020 and 2022–2024, as well as to develop composite statistical indicators for identifying staffing imbalances and forecasting human resources for the cervical cancer prevention system.

Materials and Methods. A retrospective study was conducted based on official aggregated data from the Ministry of Health and the State Statistics Service for 2015–2020 and 2022–2024. For each region, the following indicators were calculated: staffing ratio (Kz), Qualification Index (QI), Proportion of Highest-category specialists (PH), Integral Staffing index (IS_integr), and Personnel Shift Rate (PSR). Statistical analysis included descriptive statistics, correlation, and factor analysis using Excel, SPSS, and RStudio packages.

Research Ethics. The study was based solely on aggregated open statistical data containing no personal information. In accordance with the standards of the WMA Declaration of Helsinki, additional ethical approval was not required.

Results. The average annual number of gynecologic oncologists was 264. A high level of regional disparity was revealed: the coefficient of variation for Kz was 43.6%. The average QI was 0.93, which is below the normative level (≥1.20). Analysis of IS_integr showed that over a third of regions have critically low staffing potential (e.g., Luhansk and Zakarpattia regions). In some regions, staff turnover exceeded 15%. A statistically significant positive correlation was found between IS_integr and the rate of early cervical cancer detection (r=0.68; p<0.01). Regions were classified into three types: potentially stable, vulnerable, and destabilized.

Conclusions. Ukraine's gynecologic oncology service is characterized by insufficient staffing and significant regional disparities. More than one-third of regions have a critically low level of human resource potential. The established direct link between the integral staffing index and the effectiveness of early diagnosis underscores the key role of staff quality and stability. The proposed composite indicators, particularly IS_integr, can serve as an effective tool for evidence-based management planning for cervical cancer prevention for 2025–2030.

Keywords: oncogynecology, health care management, regional disproportions, cervical cancer, integral index of availability, medical statistics.