Keywords
risk
medical and economic evaluation
costs-effectiveness
essential hypertension
gastroduodenitis
How to Cite
Abstract
The medical and economic effectiveness of approaches to the prevention of gastroduodenitis in patients of retirement age with essential hypertension has been insufficiently studied. This fact necessitated this study. A combined (retrospective-prospective) study of gastroduodenitis prevention programs for retirement age patients with essential hypertension who are taking drugs under the "Affordable Medicines" program was conducted. A new theoretical model for assessing the medical and economic effectiveness of the gastroduodenitis prevention program in patients with essential hypertension with key parameters "incremental cost – effectiveness ratio" (ICER) and "incremental benefit – cost ratio" (IBCR) has been developed. The effectiveness of the proposed program was evaluated. The main factors of lifestyle and treatment that affect the development and exacerbation of gastroduodenitis in this category of patients are identified. The risks of gastroduodenitis due to non-steroidal anti-inflammatory drugs, the presence and absence of compliance, age and sex of patients, living alone (without a family), which indicate ways to improve prevention programs and determine the nature of recommendations for patients on lifestyle and treatment of hypertension. Evaluation of the effectiveness of the proposed prevention program on the criteria of ICER and IBCR allowed to determine the positive additional effect of participation in the reimbursement program, compliance, male gender, identified patient income levels at which increasing costs of prevention programs has greater economic effect. It is recommended to use the results of the study to improve the programs of prevention of hypertension in patients with hypertension at the stage of primary health care, including the cost of individual items of expenditure of the program "Affordable Medicines".
Keywords: prevention program, risk, clinical and economic evaluation, costs-effectiveness, essential hypertension, gastroduodenitis.
References
World report on ageing and health. Geneva: World Health Organization; 2015. 301 p. Available from: https://apps.who.int/iris/bitstream/10665/186468/3/WHO_FWC_ALC_15.01_rus.pdf [in Russian].
Demographic and social statistics. Population and migration. State Statistics Service of Ukraine. Available from: http://www.ukrstat.gov.ua/ [in Ukrainian].
The population of Ukraine. Imperatives of demographic aging. Kyiv: VD "ADEFUkraine", 2014. 288 p. [in Ukrainian].
Annual report on the state of health of the population, sanitary and epidemiological situation and the results of the health care system of Ukraine. 2018. Kyiv: Ministry of Health of Ukraine; IEC "Medinform", 2019. 458 p. [in Ukrainian].
Affordable Medicines. Ministry of Health of Ukraine. Available from: https://en.moz.gov.ua/affordable-medicines
Evaluation of the Affordable Medicines Programme in Ukraine. WHO Regional office for Europe. Copenhagen: WHO Regional Office for Europe; 2019. 49 p. Available from: https://www.euro.who.int/__data/assets/pdf_file/0019/400429/52308-WHO-Affordable-Medicines-Programme-Ukraine-UKR_low_V7.pdf [in Ukrainian].
Akhmedova AA, Ocheredko OM. Substantiation of the model of clinical and economic efficiency evaluation of prevention, treatment, and dispenserization of the patients with comorbidity. The example of patients with arterial hypertension and duodenitis. Medical News [Wiadomości Lekarskie]. 2018;LXXI(3-I):479–84. Available from: https://wiadlek.pl/wp-content/uploads/2020/01/WL-3-cz-I-2018.pdf [in Ukrainian].