CLINICAL AND ECONOMIC EFFICACY OF PRIMARY PREDICTION ORGANISATIONAL MODEL FOR CARDIOVASCULAR DISEASES IN RAILWAY SYSTEM WORKERS

N V Pyrikova,I V Osipova,A V Kontsevaya,I I Kurbatova,A G Salzman,O N Antropova

doi:10.15829/1560-4071-2014-6-12-18

Abstract

Aim. To study clinical and economic efficacy of the organisational model for primary prevention of CVD in men working at railway system. Material and methods. Organisational model for primary prevention of CVD (the group preventive consulting at the workplace and individualized profound prophylactic consulting in outpatient environment of locomotory depot rehabilitation centre) has been performed for the first group of locomotory teams in 20102012 y.; second group was under annual medical observation (screening and medical comission workout). The monitoring of risk factors and analysis of morbidity causing temporary disability (TD) by CVD; direct and indirect expenses calculation; expense-efficacy estimation. Results. On the background of organisational model for primary CVD prevention in the first group there was a decrease of TD from CVD by 32,8% cases and 34,6% days, from DM by 55,6%; no cases of CHD; total expenses decreased by 44,1%. For three years of observation of 2nd group there was increase of TD from CVD by 19,2% and days — by 8,7%; TD from CHD and DM increased twice; total increase of expenses was by 24,3%. In the 1st group prevalence of smoking decreases 1,6 times and expenses for 1% — decrease of this addiction reached 10304,7 RUR; prevalence of abdominal obesity decreased 1,3 times, expenses for attaining the target waist circumference in 1% patients reached 20310,7 RUR; prevalence of hypercholestrolemia was 1,8 times rarer and expenses to reduce it in 1% patients were 8493,6 RUR by 100 workers. In the 2nd group prevalence of smoking decreased by 4,7% and expenses to reduce this addiction for 1% of men were 107607,4 RUR by 100 workers, that is 10,4 times more than in the 1st group; prevalence of abdominal obesity increased by 5,5%, of hypercholesterolemia — by 4,7%. Conclusion. Realisation of the organisational model for primary CVD prevention in railway system workers during first 3 years showed clinical and economic efficacy in terms of the main risk factor prevalence decrease, TD decrease and overall expenses for CVD.

Highlights

АГ — артериальная гипертония, АД — артериальное давление, ВВП — валовый внутренний продукт, ВУТ — временная утрата трудоспособности, ДАД — диастолическое артериальное давление, ИБС — ишемическая болезнь сердца, НИИ — научно-исследовательский институт, общего холестерина (ОХС) — общий холестерин, САД — систолическое артериальное давление, СД — сахарный диабет, ССЗ — сердечно-сосудистые заболевания, хронических неинфекционных заболеваний (ХНИЗ) — хронические неинфекционные заболевания, ЧСС–частота сердечных сокращений, ЭКГ — электрокардиография
In the 1st group prevalence of smoking decreases 1,6 times and expenses for 1% — decrease of this addiction reached 10304,7 RUR; prevalence of abdominal obesity decreased 1,3 times, expenses for attaining the target waist circumference in 1% patients reached 20310,7 RUR; prevalence of hypercholestrolemia was 1,8 times rarer and expenses to reduce it in 1% patients were 8493,6 RUR by 100 workers
In the 2nd group prevalence of smoking decreased by 4,7% and expenses to reduce this addiction for 1% of men were 107607,4 RUR by 100 workers, that is 10,4 times more than in the 1st group; prevalence of abdominal obesity increased by 5,5%, of hypercholesterolemia — by 4,7%

Summary

Introduction

АГ — артериальная гипертония, АД — артериальное давление, ВВП — валовый внутренний продукт, ВУТ — временная утрата трудоспособности, ДАД — диастолическое артериальное давление, ИБС — ишемическая болезнь сердца, НИИ — научно-исследовательский институт, ОХС — общий холестерин, САД — систолическое артериальное давление, СД — сахарный диабет, ССЗ — сердечно-сосудистые заболевания, ХНИЗ — хронические неинфекционные заболевания, ЧСС–частота сердечных сокращений, ЭКГ — электрокардиография. Для оценки клинической эффективности модели первичной профилактики ССЗ у работников железнодорожного транспорта проводился мониторинг факторов риска [9] и анализ заболеваемости с ВУТ по ССЗ на 100 работающих в год: число случаев, число дней, средняя длительность одного случая, структура заболеваемости с ВУТ. Таблица 1 Затраты, ассоциированные с ССЗ, у работников железнодорожного транспорта до и после реализации организационной модели первичной профилактики (в расчете на 100 работающих)

Results

Conclusion