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Article

Медико-экономические аспекты комплексной этапной стандартизированной программы диагностики и лечения доброкачественной гиперплазии предстательной железы

Аполихин О. И., Шишкин С. В., Шейман И. М., Сивков А. В., Золотухин О. В., Шадеркин И. А., Сажина С. В., Просянников М. Ю., Войтко Д. А., Цой А. А., Григорьева М. В.

The limited resources of health care system, combined with an aging population and an increase of proportion of diseases of involutional origin leads to the need to optimize the algorithms of diagnosis and treatment of these diseases. BPH is a gender-associated, socially significant disease, as it accounts for over 40% of all diseases of men older than 50 years, and this is the reason of the significant economic contributions in the cost structure of the health system. Analysis of the effectiveness of medical care for BPH in Russia conducted by the example of the Voronezh region, has revealed several shortcomings, the key ones are: low detection rate of the disease and as a result high costs associated with the need of additional treatment in advanced cases. To improve the quality of care for patients with BPH a comprehensive program of staged standardized care was developed.

Materials and Methods: urological assistance was provided in three stages. In the first stage the problem of BPH early detection was resolved. In the second – patients underwent standart treatment procedures, including surgery. 7 interdistrict urological centers representing second stage were deployed. On the basis of the regional clinical hospital №1 regional urological center was organized – the third stage, where specialists delivered treatment in severe clinical cases.

Results: As a result of program activities, there was a reduction of the specific economic costs in terms of each patient at 21.68%. Number of patients admitted for acute urinary retention as complications of BPH significantly reduced. Surgical activity of interdistrict urological centers (based on central district hospitals) increased at 76,11%.

Conclusions: All given facts show high clinical and economic efficiency of comprehensive staged standardized program of care for patients with BPH, based on the principles of early diagnosis and timely treatment.