REMEDIUMREMEDIUM1561-59362658-3534Joint-Stock Company Chicot174010.32687/1561-5936-2025-29-1-64-68Original ArticleCost-effectiveness of increasing the function of the medical position of a district physician-phthisiatristBezuglayaSvetlana Yu.bezuglayasy@zdrav.mos.ruPosadskyMikhail Yu.posadskiy.mikhail@gmail.comKrivtsovaOlga V.olgavkk@mail.ruTuktarovaLyudmila M.tuktarovalm@zdrav.mos.ruBogorodskayaElena M.el_bogorodskaya@mail.ruMoscow City Scientific and Practical Center for the Fight against Tuberculosis, Moscow, RussiaResearch Institute of Healthcare Organization and Medical Management of the Moscow Health Department, Moscow, RussiaCentral Research Institute of Tuberculosis, Moscow, Russia, Russian Medical Academy of Continuing Professional Education, Moscow, Russia151220251646815102025Copyright © 2025,2025Relevance. Due to the decrease in the incidence of tuberculosis, the workload of a phthisiatrician associated with the treatment of patients has decreased; therefore, it is necessary to study the distribution of working time of a phthisiatrician and the economic efficiency of his work. Objective of the study: to investigate the economic efficiency of increasing the workload of a district phthisiatrist during the period of relative epidemic favorability of tuberculosis. Materials and methods. We studied the functions of a district physician-phthisiatrist from 2013 to 2023, working in the MNPC of tuberculosis control. We analyzed the cost per visit from 2013 to 2023 and its dynamics as a percentage of the base year 2013. Results discussion. Over the last 11 years, the function of a physician position increased by 184.2% or 2.8 times from 2501.1 in 2013 to 7107.8 in 2023. The structure of the physician position function changed: the share of visits for illness decreased 2.8 times from 68.2% to 24.3%, and for preventive purposes increased 2.4 times from 31.8% to 75.7%. When analyzing the duration of visits to a physician-phthisiatrist, we found that the time it takes to see a patient is 51.0 ± 2.3 min, where 34 min — familiarization with medical documentation and direct examination of the patient and 17 min. — on execution of medical documentation. Over 11 years, the cost of a visit increased 2.85 times, the cost of a case of hospitalization — 2.1 times. If the share of visits remained the same as in 2011, the costs of outpatient care would have increased by 15.9% as compared to the actual costs, and the costs of inpatient care — 19.1%. Overall, costs would increase by 17.6% relative to actual 2023 costs. Conclusion. With decreasing epidemiological indicators on tuberculosis within the dispensary outpatient work of a physician-phthisiatrist is characterized by a decrease in the workload associated with the treatment of patients. It seems possible to redistribute the doctors time with an increase in the volume of preventive work aimed at eliminating tuberculosis as a widespread disease. The time spent on one visit is significantly lower than the time spent on a disease-related visit and allows increasing the function of a medical position during the working time of a district TB doctor. At increase of the allocated time of the doctor for preventive appointments of risk groups the costs of both outpatient care and treatment in the hospital in the long term are reduced.district physician-phthisiologistfunctions of medical positiontuberculosis patientpreventive workadvisory purposepurpose of diagnosticsreduction of main epidemiological indicatorsврач-фтизиатр участковыйфункции врачебной должностибольной туберкулёзомпрофилактическая работаконсультативная цельцель проведения диагностикиснижение основных эпидемиологических показателей1.Nezlin S. E., Greimer M. S., Protopopova N. M. Anti-tuberculosis dispensary. Moscow; 1989. 2nd ed. (In Russ.)2.Yashchenko B. P., Dvorin M. S. Manual on phthisiology. Kyiv; 1986. (In Russ.)3.Sterlikov SA, Nechaeva OB, Son IM, et al. Industry and economic indicators of anti-tuberculosis work in 2019—2020. Analytical review of the main indicators and statistical materials. Moscow; 2021. (n Russ.)4.Bogorodskaya EM, Belilovsky EM, Bezuglaya SYu, et al. Organization of monitoring of tuberculosis infection foci in the megalopolis. Tuberculosis and socially significant diseases. 2022;10(3):4—16. DOI: 10.54921/2413-0346-2022-10-3-4-16