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Main arrow Archive of previous Issues arrow 2 2012 (24) arrow Medical and economic evaluation and substantiation of the technologies and programs for budgeting of inpatient care in ischemic heart disease: brief literature review
Medical and economic evaluation and substantiation of the technologies and programs for budgeting of inpatient care in ischemic heart disease: brief literature review Print
Friday, 13 April 2012

S.A. Martynchik1, S.V. Filatenkova2
1
I.M. Sechenov First Moscow State Medical University, Moscow
2Polyclinic 6 at the Federal Security Service of Russia, Moscow

Summary. A brief review of the foreign and domestic literature that had been devoted to evaluation of the social economic burden associated with ischemic heart disease was compiled. Under this burden a whole complex of factors was meant here, including social, economic, and organizational ones. The latter implied a wide range of problems including elevating medical access through organizational measures, improving the quality of medical care, and enhancing efficiency of budget funding.

Expediency of program-target approach to managing programs of funding for acute coronary syndrome associated with high risk of instantaneous death and fatal/non-fatal myocardial infarction was appreciated.

Adopted programmed measures for improving organizational patterns of delivering medical care were investigated into, including wide introduction of endovascular technologies of re-perfusion therapy and measures of secondary prevention of ischemic heart disease following old myocardial infarction. Optimization of operation of the facilities of cardiac profile necessitates economic substantiation of technologies and programs of budgeting, including creation of national hospital register and introduction of the quality control system for providing medical care on the basis of standards of medical care and target indicators.

Quality of medical care and medical access for the population were studied in connection with the efficiency of budget expenditure for medical facilities. Cost evaluation of expenditure per completed case of medical care in coronary syndrome was performed. Efficacious means of reimbursement for expenditure implying immediate and remote receipts were assessed.

Economically expedient means of financial provision of the programs for the improvement of methodological foundation of standardization of all ways of expenditure was considered here, including development of methodological foundation for such standardization, procedure of planning with the use of enlarged volumes of medical care, grouping of patients along the criteria of clinical and outlaying similarity, establishment of standards of financial costs and differentiated tariffs that would imply elevation to new therapeutic and diagnostic highlights, predictability in fulfillment of programs and measures, creation of certain stimuli for reducing expenditure and efficient management of the materiel resources.

Keywords. Acute coronary syndrome; unstable angina pectoris; myocardial infarction; hospital lethality; endovascular techniques of diagnosis and treatment; thrombolytic therapy; hospital registers; standardization of expenditure; clinical statistical groups; standards of financial expenditure; means of prospective payment; programmed budgeting aimed to result.

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