Working time expenditures in a district TB doctor for dispensary and extra-dispensary work in conditions of a favorable epidemiological situation

Introduction. With the decline in the intensity of the tuberculosis epidemic, the number of patients has significantly decreased. Therefore, the majority of the district TB physician’s time is now devoted to measures to prevent further increases in tuberculosis incidence.

Purpose: to assess the actual time expenditures of district TB physicians in the context of declining key epidemiological indicators.

Materials and methods. The study was conducted in 2023 at the «Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Department of Health». There was used the methodology developed by the Central Research Institute of Occupational Medicine and Infection Control of the Ministry of Health of the Russian Federation. The developed flow chart recorded time measurements for various functions in the district TB physician during outpatient appointments and during outpatient work. The charts were completed for four thousand two hundred eighty eight patients. Time charts were differentiated based on the purpose of the visit, the time of the year, and type of outpatient work. A total of 107 district TB physicians (48%), out of 222 working in 189 districts serving the adult population, participated in the study.

Results. Outpatient appointments accounted for 66.8% of their time. Outpatient visits accounted for 21.03% of their time, with the majority (37.0%) spent visiting TB hotspots and 26.8% spent visiting non-TB healthcare facilities to provide managing and methodological assistance.

Research limitations. We examined the time expenditure of district TB physicians in a city with good transportation accessibility, close proximity to healthcare facilities, and a favorable epidemiological situation.

Conclusions. On average, district TB physicians devote 21.0% of their monthly work time to outpatient work, while 66.8% of their time spent on outpatient appointments. Furthermore, the state assignment structure is based solely on outpatient visits.

Compliance with ethical standards. The conclusion of the medical ethics committee was not required to conduct this study.

Contribution of the authors:
Bezuglaya S.Yu. — collection and processing of material, statistical data processing, data analysis, writing of text;
Bogorodskaya E.M. — concept and design of the study, data analysis, writing of text, editing, approval of the final version of the article;
Odintsov V.E. — editing, approval of the final version of the article;
Afanasyeva R.R. — collection and processing of material, statistical data processing, writing of text.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: April 8, 2025 / Accepted: December 17, 2025 / Published: March 4, 2026