Abstract
The goal of this research was to value of primary prevention of myocardial infarction using clinico-economical indices and to find a way of raising efficiency of its. The costs of treatment 17 378 patients up to 70 years old with stenocardia and expense amount of treatment in out-patient, inpatient departments and ambulance were estimated on the basis of compulsory medical insurance rates. Probability of myocardial infarction in patients with stenocardia was evaluated in relation to medical aid appealability to medical organizations. It was found 31% patients with stenocardia do not seek medical advice in out-patients. Meanwhile probability of myocardial infarction in those patients in 2.3 times higher than in patients received treatment in out-patients. It was found also that 1.0 ruble investment to prophylactic medical examination for patients with stenocardia gives profit 8.5 rubles in view of saved person-years and reducing of treatment expense. That profit can be raised twice by the using of “recipientoriented” primary prevention of myocardial infarction. “Recipient-oriented” primary prevention of myocardial infarction is realized in cooperation of medical organizations, health insurance companies and compulsory medical insurance fund.
Highlights
The goal of this research was to value of primary prevention of myocardial infarction using clinico-economical indices and to find a way of raising efficiency of its
The costs of treatment 17 378 patients up to 70 years old with stenocardia and expense amount of treatment in out-patient, inpatient departments and ambulance were estimated on the basis of compulsory medical insurance rates
Probability of myocardial infarction in patients with stenocardia was evaluated in relation to medical aid appealability to medical organizations
Summary
Цель исследования: дать клинико-экономическую оценку первичной профилактике инфаркта миокарда (ИМ) и найти варианты ее проведения с большей эффективностью. У 17 378 больных стенокардией в возрасте до 70 лет нами были определены финансовые затраты на лечение в поликлинике, стационаре и скорой медицинской помощи (СМП), исходя из тарифов фонда обязательного медицинского страхования (ОМС), и рассчитана сумма финансовых средств, потраченных на лечение ИМ. Определили, что 31% больных стенокардией не обращаются по поводу данного заболевания в поликлинику, при этом вероятность возникновения ИМ у них в 2,3 раза выше, чем у больных, проходящих лечение в поликлинике в связи со стенокардией. Что вложение одного рубля в диспансеризацию больных стенокардией дает прибыль в форме сохраненных человеко-лет и в форме снижения финансовых затрат на лечение ИМ в 8,5 рублей. Данную прибыль можно увеличить в два раза при проведении «адресной» первичной профилактики ИМ. Вариант «адресной» первичной профилактики ИМ реализуется при взаимодействии медицинских организаций, медицинских страховых компаний и Фонда ОМС в решении вопросов диспансеризации больных стенокардией.
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