Clinical and economic analysis of the application of the method of three-dimensional reconstruction of lung tissue in the practice of tuberculosis institution

Abstract

Background. The use of clinical and economic analysis in practical healthcare allows for a more rational use of the resources allocated by the state and contributes to the achievement of optimal indicators in terms of the quality of disease identification and the effectiveness of its treatment.
 Aim. To conduct a clinical and economic analysis of the prospects for introducing the 3D lung reconstruction method into tuberculosis practice, which is used to correct the level of adherence, reduce the severity of symptoms of anxiety and depression, and increase the effectiveness of chemotherapy.
 Materials and methods. In this scientific work, the results of treatment (more than 90 people) of newly diagnosed patients with destructive pulmonary tuberculosis, which were observed in the Nizhny Novgorod Regional Clinical Tuberculosis Dispensary, were used. The patients were divided into two groups. For the 1st group of patients, tactile lung models were made, among them a questionnaire was conducted using the MMAS-4 questionnaire and the HADS scale. For patients of the 2nd group, lung models were not made, and no survey was conducted. Each group was assessed the effectiveness of chemotherapy. Clinical and economic analysis of the cost of introducing the method of three-dimensional lung reconstruction into tuberculosis practice was carried out on the basis of two evaluation criteria «cost – effectiveness» and «cost-effectiveness increment» with additional mathematical calculations of the necessary indicators. The results obtained were compared with the existing known method of increasing adherence to tuberculosis treatment - the issuance of food packages.
 Results. Based on the results of the study, it was proved that the use of tactile models of the lungs in phthisiatric practice is more than 8 times cheaper than the method of issuing food kits with, in fact, comparable results of treatment effectiveness. If there is a need to increase the effectiveness of the treatment of tuberculosis patients by increasing the subsidy of food packages, the cost of one additional percent of efficiency is not economically viable.
 Conclusion. The clinical and economic analysis of the prospects for introducing the method of three-dimensional lung reconstruction into phthisiatric practice presented in the paper looks promising, which is confirmed by the performed mathematical calculations and comparisons, and can be recommended for use in the routine practice of phthisiatricians to correct the level of adherence of tuberculosis patients to chemotherapy, reduce the severity symptoms of anxiety and depression, as well as an increase in the effectiveness of treatment.