Clinical and Economic Aspects of Surgical Care Elderly Patients

Abstract


Relevance Study of the modern model of healthcare sector in Russia in terms of effective use of limited health care resources, is
very important. Especially because now there is virtually no research on the clinical and economic features of surgical care elderly
people, whose share in the community has clear upward trend.
The purpose of the study Study the modern clinical and economic model of surgical care to patients of old age, to identify its
weaknesses, to identify ways to optimize.
Materials and methods The subject of the study was contingent elderly patients treated in surgical hospitals in Belgorod. In the
study of the rehabilitation phase of surgical care to patients of old age, the method of interview. The study of the economic aspects
of surgical care performed by studying official documentation of regional fund of obligatory medical insurance and then applying
the method of expert estimates. Materials and Methods: The subject of the study was contingent elderly patients treated in surgical
hospitals in Belgorod. In the study of the rehabilitation phase of surgical care to patients of old age, the method of interview. The
study of the economic aspects of surgical care performed by studying official documentation of regional fund of obligatory medical
insurance and then applying the method of expert estimates.
Results and their discussion Investigated the clinical and epidemiological characteristics of elderly patients surgical: structure
analysis of surgical and comorbidities in patients of older age groups, the impact of polymorbidity on the course of the disease
and surgical treatment strategy of patients. For the analysis of the rehabilitation phase interviewed 98 convalescent 1-2 years after discharge from hospital. Explore different models of health care and care for the sick, a detailed study of the current Russian economic model clinical-surgical care elderly patients, analyzed the possible payment options patient care in the statutory health insurance, consider payment for inpatient hospitalization completed case, used in the Belgorod region. Conclusions The results show the prevalence of disease in the structure of cholelithiasis, acute pancreatitis, and vascular diseases of the lower limbs, and chronic inflammatory diseases. In 58,7% of patients with acute surgical pathology could arrest the conservative methods, but conservative treatment of the treated patients required readmission to 21,5% of patients. Clinical and economic model of surgical care elderly people is focused on reducing the time of treatment, is characterized by the direct dependence on the amount of the income, while at the same time, there is an unjustified reduction in health care, the lack of incentive to limit the overall costs. Important ways to optimize clinical and economic model of surgical care to people of old age is to introduce a system of differentiated tariffs paid per case (outcome) to form a target group of patients, taking into account gender, age of the patients, the complexity of the required medical treatment, as well as the introduction of a full rehabilitation healthcare.


National Research University, «BSU», Belgorod, Russian Federation;
Independent non-profit organization Research medical center «Gerontology», Moscow, Russian Federation

Author for correspondence.
Email: author@vestnik-surgery.com
MD, PhD, Department of General Surgery with the course of topographic anatomy and operative surgery NIU «BSU», Belgorod

National Research University, «BSU», Belgorod, Russian Federation;
Independent non-profit organization Research medical center «Gerontology», Moscow, Russian Federation

Email: author@vestnik-surgery.com
PhD., Professor, Director of Independent non-profit organization Research medical center «Gerontology», Moscow

National Research University, «BSU», Belgorod, Russian Federation;
Independent non-profit organization Research medical center «Gerontology», Moscow, Russian Federation

Email: author@vestnik-surgery.com
doctor - intern specialty «surgery» IPMO NRU «BSU», Belgorod

  1. Gerasimenko N.I. Reforma zdravookhraneniya: nekotoryye rezul'taty i
  2. perspektivy [Health care reform : some results and
  3. prospects]. Ekonomika zdravookhraneniia, 1997; 1: 5-7. - (In
  4. Russian)
  5. Giliarovskii S.R., Orlov V.A. Ispol'zovaniye analiza
  6. effektivnosti lecheniya dlya klinicheskogo resheniye v
  7. kardiologii [Use of the analysis of
  8. efficiency of treatment for the clinical decision in a
  9. cardiology]. Kardiologiia, 1997; 37: 70-80. - (In Russian)
  10. Giliarovskii S.R. Sovremennyye printsipy ekonomicheskoy effektivnosti analiza meditsinskikh vmeshatel'stv [Modern principles of cost-effectiveness analysis of medical interventions]. Ekonomika
  11. zdravookhraneniia, 2001; 9: 15-20. - (In Russian)
  12. Kalashnikov V.Iu., Sereda E.G., Glezer M.G., Syrkin A.L. Kliniko-ekonomicheskiy analiz lecheniya bol'nykh starshe 65 let s retsidiviruyushchey fibrillyatsiyey predserdiy [Clinical and economic analysis of the treatment of patients older than 65 years with relapsing atrial fibrillation].
  13. Problemy standartizatsii v zdravookhranenii, 2007; 2: 47-
  14. - (In Russian)
  15. Kamyshanchenko E.N., Gorelik S.G., Proshchaev K.I.,
  16. Kononova E.V. Ekonomicheskaya otsenka effektivnosti
  17. tekushchey modeli zdravookhraneniya v Rossii [Economic assessment of the effectiveness of current health care model in Russia]. Materialy
  18. Mezhdunarodnoi nauchno-prakticheskoi konferentsii
  19. «Sovremennye problemy sotsial'no-ekonomicheskogo
  20. razvitiia Rossii» [Proc. Int. Conf. "Modern problems of
  21. socialand economic development of Russia"]. Belgorod,
  22. , 66-171. - (In Russian)
  23. Mikhailov F.V., Filatov V.N. Metodika rascheta
  24. tarifov na meditsinskiye uslugi v bol'nitsakh [Methodology for calculating
  25. tariffs for health services in hospitals]. Ekonomika
  26. zdravookhraneniia, 2000; 2. - (In Russian)
  27. Rusiantsev Iu. Finansirovaniye zdravookhraneniya v razvitykh
  28. strany [Financing of health care in developed
  29. countries]. Vrach, 1999; 1: 42-43. - (In Russian)
  30. Shishkin S.V. Reforma finansirovaniia rossiiskogo
  31. zdravookhraneniia [Russian health care financing reform].
  32. Moscow, 2000. 42 p. - (In Russian)
  33. Kamlet M.S. Sravnitel'nyye preimushchestva Modelirovaniye proyekta:
  34. Ramki Analiz poleznosti zatrat Pravitel'stva zdravookhraneniya
  35. Ukhod programm. Vashington, okrug Kolumbiya: Sluzhba obshchestvennogo zdravookhraneniya [The Comparative Benefits Modeling Project: A
  36. Framework for Cost-Utility Analysis of Government Health
  37. Care Programs. Washington, DC: Public Health Service].
  38. US Dept of Health and Human Services 1992; 195 p.
  39. Rich M.W., Nease R.F. Analiz ekonomicheskoy effektivnosti v
  40. klinicheskoy praktike: sluchay serdechnoy nedostatochnosti [Cost-effectiveness Analysis in
  41. Clinical Practice: The Case of Heart Failure]. Arch. Intern.
  42. Med., 1999; 159: 15: 1690-1700.

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