Farmakoekonomika最新文献

{"title":"Increasing the medico-economic efficiency of preventive counseling for patients with arterial hypertension and behavioral risk factors for non-communicable diseases","authors":"O. Zadvornaya, A. Pishchita","doi":"10.17749/2070-4909/farmakoekonomika.2021.074","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2021.074","url":null,"abstract":"Objective: to evaluate behavioral risk factors (BRF) in patients with arterial hypertension (AH) and to determine the ways of improvement of the approaches to preventive consulting targeted to increase medico-economic efficiency of the prevention of cardiovascular diseases (CVDs).Material and methods. A total of 107 patients aged 40–60 years old that attended health-promoting schools for patients with AH at the institutions of primary medical help in Moscow in 2017–2019 were surveyed. The authors used diagnostic criteria of the risk factors for noncommunicable diseases that have behavioral character according to the classification of the World Health Organization (WHO). Along with that, the authors reviewed the opinion of 128 top managers of the institutions of primary medical help that attended the courses of their qualification improvement “Organization of public healthcare” in 2019. The course was dedicated to the possible ways of improvement of preventive consulting of patients with AH and BRF. The methods of content analysis, synthesis, statistical analysis, comparison, etc. were applied. The authors analyzed the documentation on the prevention of CVDs, scientific publications on the subject from eLibrary, Cochrane Library, PubMed, Scopus databases, and official sites of biomedical journals.Results. The sociological survey revealed data on the presence of BRF of non-communicable diseases in patients aged 40–60 years old with verified AH based on scientifically proven criteria and WHO classification. These criteria allowed to evaluate the degree of the proneness of patients with AH to the influence of harmful risk factors (smoking, alcohol consumption, lack of physical activity, unhealthy eating habits) and their combinations. The sociological survey data obtained from the top management of institutions of primary medical help indicated the necessity of the improvement of approaches to group preventive consulting of patients with AH and BRF.Conclusion. The results of the study revealed the main areas of the systemic mistakes in the preventive consulting of patients with AH that have BRF, associated with the evaluation of individual-psychological peculiarities of a personality, and in the organizational aspects of preventive counseling.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80961055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 pandemic prediction model based on machine learning in selected regions of the Russian Federation","authors":"D. V. Gavrilov, R. Abramov, А. V. Kirilkina, А. Ivshin, R. Novitskiy","doi":"10.17749/2070-4909/farmakoekonomika.2021.108","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2021.108","url":null,"abstract":"Background. Prediction of the new coronavirus infection (COVID-19) spread is important to take timely measures and initiate systemic preventive and anti-epidemic actions both at the regional and state levels to reduce morbidity and mortality.Objective: to develop a model for short-term forecasting of COVID-19 cases and deaths in the Russian Federation.Material and methods. The data for the model training were collected from the Stopcoronavirus.rf and Johns Hopkins University portals. It included 13 features to assess the infection dynamics and mortality, as well as the rate of morbidity and mortality in different countries and certain regions of the Russian Federation. The model was trained by the CatBoost gradient boosting method and retrained daily with updated data.Results. The forecast model of COVID-19 cases and deaths for the period of up to 14 days was created. The mean absolute percentage error (MAPE) estimate of the model’s accuracy ranged from 2.3% to 24% for 85 regions of the Russian Federation. The advantage of the CatBoost machine learning method over linear regression was shown using the example of the root mean square error (RMSE) value. The model showed less error for regions with a large population than for less populated ones.Conclusion. The model can be used not only to predict the pandemic of the novel coronavirus infection but also to control and assess the spread of diseases from the group of new infections at their emergence, peak incidence, and stabilization period.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78963930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning based on laboratory data for disease prediction","authors":"A. Gusev, R. Novitskiy, A. Ivshin, A. A. Alekseev","doi":"10.17749/2070-4909/farmakoekonomika.2021.115","DOIUrl":"https://doi.org/10.17749/2070-4909/farmakoekonomika.2021.115","url":null,"abstract":"Objective: to review domestic and foreign literature on the issue of machine learning methods applied in medical information systems (MIS), to analyze the accuracy and efficiency of the technologies under study, their advantages and disadvantages, the possibilities of implementation in clinical practice.Material and methods. The literature search was performed in the PubMed/MEDLINE databases covering the period from 2000 to 2020 (using groups of keyphrases: \"machine learning\", \"laboratory data\", \"clinical events\", \"prediction diseases\"), CyberLeninka (\"machine learning\", \"laboratory data\", \"clinical events\", \"prediction diseases\" Russian keyphrases combinations) and Papers With Code (\"clinical events\", \"prediction diseases\", \"electronic health record\"). After reviewing the full text of 30 literature sources that met the selection criteria, the 19 most relevant articles were selected.Results. An analysis of sources that describe the application of artificial intelligence techniques to obtain predictive analytics, taking into account information about patients, such as demographic, anamnestic, and laboratory data, the data of instrumental studies, information about existing and former diseases available in MIS, was performed. The existing ways of predicting adverse medical outcomes using machine learning methods were considered. Information about the significance of the used laboratory data for constructing high-precision predictive mathematical models is presented.Conclusion. Implementation of machine learning algorithms in MIS seems to be a promising tool for effective prediction of adverse medical events for wide application in real clinical practice. It corresponds to the global trend in the development of personalized medicine based on the calculation of individual risk. There is an increase in the activity of research in the field of predicting noncommunicable diseases using artificial intelligence technologies.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76359167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Near miss” in obstetrics: classification, evaluation, and significance for healthcare technology assessment","authors":"I. K. Мamontova, T. V. Shevlyakovа, E. Petrova","doi":"10.17749/2313-7347.2018.11.4.092-096","DOIUrl":"https://doi.org/10.17749/2313-7347.2018.11.4.092-096","url":null,"abstract":"To reduce maternal mortality, it is important to analyze the clinical conditions posing a potential threat to pregnant women. To characterize such states, the definition was introduced – “maternal morbidity, which almost took the woman’s life” (the near miss maternal morbidity), or the “near miss”. The “near miss” criteria were first defined in 2009. This review article provides a rationale for auditing the “near miss” cases for the purposes of healthcare technologies asessment. The paper also discusses the clinical and economic aspects of “near miss” analysis and the methodology for assessing the “near miss” incidence. Also of scientific and practical interest is the classification of maternal “near miss” cases developed by our colleagues from theRostovPerinatalCenter. Thus, maternal “near miss” cases are divided into obstetric (emergency), extragenital, planned (managed), organizational, and iatrogenic. This differentiated approach to the maternal critical conditions allows us to understand not only their causes, but also to develop a plan of further actions for each specific group. This contributes to the development of rehabilitation and prevention measures to be taken during subsequent pregnancies.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78808252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Costs of pharmacotherapy in pediatric patients with community-acquired pneumonia: mathematical and statistical analysis","authors":"I. Narkevich, O. D. Nemyatyh, D. D. Siukaeva, I. V. Pavlushkov, D. Ivanov, Ya V Panyutina","doi":"10.17749/2070-4909.2018.11.4.028-037","DOIUrl":"https://doi.org/10.17749/2070-4909.2018.11.4.028-037","url":null,"abstract":"The aim of the study is to determine the limits of using the mathematical-statistical analysis for the evaluation of pharmacotherapy costs in pediatric inpatients diagnosed with community-acquired pneumonia. Materials and methods. The report is based on the assessment of 547 medical records of patients with community-acquired pneumonia, who underwent the treatment in four pediatric hospitals in St. Petersburg. The data array was created from a number of factors that characterize the patients’ profile (gender, duration of hospital stay, cost of therapy, number of prescribed drugs, number of affected lung segments, pathogen location, leukocyte count, and eSR). Results. Correlation analysis allowed us to identify factors contributing to the cost of pharmacotherapy (at a significance of p=0.05); those were: the duration of hospital stay (r=0.34), the number of prescribed drugs (r=0.26), and the number of affected lung segments (r=0.21). Dispersion analysis of qualitative factors (gender, location of pneumonic infiltrate) showed no significant impact of these factors on the costs or the number of prescribed drugs in the total data set. From the regression analysis, we obtained formulas for the dependence of the resulting parameters (cost of pharmacotherapy, number of prescribed drugs) on a set of independent variables. Conclusion. The treatment cost optimization in pediatric patients with community-acquired pneumonia should include the use of antibacterial drugs with proven efficacy and safety, as well as a reduction in non-necessary supporting therapy, e.g., medications aimed to correct morphological and functional changes in the respiratory system.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"479 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79950297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organization and financial support of healthcare for public employees in the Russian Federation: a review of departmental health services in the Ministry of Defense","authors":"D. Lukyantseva, L. Melnikova, D. Fedyaev, T. Bezdenezhnykh, V. Omelyanovskiy","doi":"10.17749/2070-4909.2018.11.4.081-091","DOIUrl":"https://doi.org/10.17749/2070-4909.2018.11.4.081-091","url":null,"abstract":"The review outlines the main legislative aspects of organization and financial support of health services for public institution employees inRussia. Specifically, the review describes the legal framework and regulations of healthcare for servicepersons and other staff within the Ministry of Defense of theRussian Federation. We discuss the financing mechanisms of the departmental health service in the Ministry of Defense. Conclusions are made on the need to improve the legislative base of financial and administrative support of healthcare for the military and associated personnel.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89897487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International experience in determining the cost-effectiveness thresholds","authors":"T. Bezdenezhnykh, N. Musina, V. K. Fedyaeva, T. S. Tepcova, V. Lemeshko, V. V. Omelyanovsky","doi":"10.17749/2070-4909.2018.11.4.073-080","DOIUrl":"https://doi.org/10.17749/2070-4909.2018.11.4.073-080","url":null,"abstract":"The article reviews international methodological guidelines, regulatory documents and existing approaches to the determination of the costeffectiveness threshold (CeT), also known as the willingness-to-pay threshold (WTP), the threshold value of the incremental cost-effectiveness ratio (ICeR), in europe (england and Wales, Scotland, Ireland, France, Belgium, Denmark, the netherlands, Germany, Sweden, Finland, norway, Poland), America (the USA, Canada, Brazil), Asia (Japan, South korea, Taiwan, Thailand), in Australia and new Zealand. The CeT is commonly used to rationalize decision-making in health cost reimbursement. The present review demonstrates that just a few countries (englandandWales,Thailand,Poland,USA) have introduced the explicit value of CeT into their decision making. Some countries (Australia,Canada,new Zealand, thenetherlands,Sweden, andBrazil) use CeT in an implicit manner implying that no specific CeT value is defined by law. In other countries (Finland,Sweden,norway,France,Germany,Denmark,Japan,South korea,Taiwan), the role of the threshold in health reimbursement remains uncertain despite the presence of HTA systems. The CeT is expressed as additional cost per unit of incremental health benefit, which is represented by quality-adjusted life year (QALY) in most counties. However,PolandandBrazilallow using life years gained (LYG) as a measure of additional benefit neglecting the quality of life. In thenetherlandsandengland, different CeT values are applied to the health technology under assessment depending on the severity or rareness of the disease and some other factors.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74417030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling the effect of enzyme replacement therapy on life-threatening complications in patients with Fabry disease","authors":"V. Ignatyeva, S. Moiseev, N. Bulanov, E. A. Karovajkina, A. Moiseev","doi":"10.17749/2070-4909.2018.11.4.038-046","DOIUrl":"https://doi.org/10.17749/2070-4909.2018.11.4.038-046","url":null,"abstract":"Fabry disease (FD) is a severe lysosome storage disease caused by congenital deficiency of the enzyme α-galactosidase A and characterized by the risk of renal failure combined with cardiovascular and CNS complications. According to the currently available information, the early start of enzyme replacement therapy (ERT) leads to a significant improvement in patient’s condition.The aim of the studyis to assess whether the timely ERT prevents severe FD complications and to calculate the number of prevented cases as depending on the time of ERT start.Materials and methods. The proposed model is based on the published results on patients with FD, receiving agalsidase alpha as ERT (no data for agalsidase beta was found). The expected number of cases with life-threatening complications was calculated for different starting timepoints and durations of the ERT.Results. In patients with FD, continuous ERT during five years reduces the number of serious cardiovascular and renal complications by 25%. An early start of ERT makes it possible to additionally (as compared with a late start) prevent the complications in more than 20% of cases.Conclusion. The early initiation of RPT in patients with FD can significantly reduce the occurrence of severe lifethreatening complications, increase the patients’ survival and improve their quality of life. ","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83102595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and economic studies on pharmacotherapy of malignant neoplasms: the modeling approach","authors":"A. Tolkushin, S. Zyryanov, N. Pogudina, M. Davydovskaya","doi":"10.17749/2070-4909.2018.11.4.048-060","DOIUrl":"https://doi.org/10.17749/2070-4909.2018.11.4.048-060","url":null,"abstract":"The aimis to develop a generalized algorithm and methodology for conducting clinical and economic studies (CeS) on medications used in treatment of malignant neoplasms (MnP).Materials and methods. We conducted a literature search and then reviewed the recent reports on similar CeS. In so doing, we paid special attention to the model type, the modeling methodology, information on the effectiveness and cost, the cost elements, performance criteria, the assessment of the CeS final results, as well as the possibility of applying these results to the national healthcare system. We used the methods of generalization, systematization, as well as visual-graphical and mathematical modeling.Results. A general algorithm for conducting a pharmacoeconomic study has been proposed; this includes an effectiveness analysis, a cost analysis and a comparison of costs and effectiveness (cost-effectiveness). The effectiveness analysis includes selection, digitization, and approximation of overall survival (OS) and progression-free survival (PFS) curves followed by their extrapolation. The choice of extrapolation method is discussed. The cost analysis includes calculating the cost of medications in question, the costs associated with the indicated therapy and with adverse events (Ae), as well the costs associated with disease progression (for certain drugs). The possibility of analyzing indirect and non-medical costs is also discussed. A dynamic version of the Markov model pertaining to the first order course of a disease is proposed; this includes the status before progression (first-line therapy), after progression (second-line therapy) and death. Considering the succession of treatments and the availability of additional data, a similar second-order model (and subsequent orders) can be applied to incorporate additional patient’s condition after the first progression to the second progression (second-line therapy) and after the second progression (third-line therapy).Conclusion. A generalized algorithm has been developed and proposed for carrying out CeS of medicationsused in MnP.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88871802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial statistical reporting by medical organizations: shortcomings and areas of optimization","authors":"M. L. Lazareva, I. Tyurina","doi":"10.17749/2070-4909.2018.11.4.061-066","DOIUrl":"https://doi.org/10.17749/2070-4909.2018.11.4.061-066","url":null,"abstract":"The article discusses some of the shortcomings in financial statistical reports provided by medical organizations in the healthcare sector, namely: duplication and intersection of indicators in different reporting forms, the inconvenient data format for their presentation and analysis, the lack of correlation between indicators of statistical reporting and internal management accounting. To solve these problems, the authors propose the ways of improving the financial reporting by medical organizations: among them, optimizing the system of indicators, abandoning the statistical reporting forms in favor of creating databases (possibly, with outsourcing assistance), as well as creating the uniform rules for maintaining internal management accounting in medical organizations.","PeriodicalId":36464,"journal":{"name":"Farmakoekonomika","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82847368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}