Сравнительная оценка клинико-экономической эффективности немедленной последовательной двусторонней хирургии катаракты и отсроченной последовательной двусторонней хирургии катаракты

Abstract

Рurpose. Comparative evaluation (from the standpoint of the Compulsory Medical Insurance Fund, CHI) of the clinical and economic efficiency of immediate sequential bilateral cataract surgery (ISBCS) and delayed sequential bilateral cataract surgery (DSBCS). Material and methods. The assessment was based on the calculation of direct medical and indirect costs of the operation. The cost of preoperative preparation in accordance with the rules of hospitalization in the surgical department was calculated on the basis of compulsory medical insurance rates for 2022. Results. The total costs (from the perspective of the compulsory health insurance fund) during the implementation of the DSBCS are 44.2 % higher than in the case of the ISBCS, which is generally consistent with the alternative calculations made in other countries (Finland, USA, Canada). Conclusion. The leading factor in the introduction of ISBCS into wide clinical practice is the development of a technology that provides comparable (with DSBCS) clinical results in terms of the level of intra and postoperative complications (especially endophthalmitis), the achieved values of BCVA, refraction of the “goal” and “quality of life” of the patient. In this case, ISBCS is characterized (compared with DSBCS) by a number of significant advantages associated with faster recovery of binocular vision, the possibility of surgical treatment of cataracts in a difficult epidemiological environment (reducing the use of personal protective equipment, minimizing repeated visits), more efficient workload in the operating room and less treatment costs from the standpoint of the state and the patient. Keywords: cataract phacoemulsification, medical expenses for treatment, compulsory medical insurance fund.