Farmakoekonomska evaluacija fakoemulzifikacije i ekstrakapsularne ekstrakcije u operaciji katarakte
Sažetak
Uvod/Cilj. Operacija katarakte predstavlja jednu od najčešće primenjivanih hirurških intervencija. U zapadnim zemljama, dominantna tehnika je fakoemulzifikacija, dok je u zemljama u razvoju najzastupljenija tehnika ekstrakapsularne ekstrakcije (ECCE). Cilj rada bio je da se proceni ekonomska isplativost te dve tehnike operacije katarakte iz perspektive pružaoca usluge, ukoliko se kao ishod posmatraju komplikacije. Metode. Podaci su dobijeni sa Očnog odeljenja Opšte bolnice Kruševac tokom jednogodišnjeg perioda. Ukupno je izvedeno 1 179 operacija od strane pet hirurga. Ekonomska isplativost je procenjena primenom „drveta odlučivanja“. Verovatnoće za događaje su izračunate na osnovu verovatnoće pojavljivanja tokom navedenog perioda. U analizi su razmatrani samo direktni troškovi, a vrednosti su preuzete iz prateće dokumentacije i zvaničnog cenovnika zdravstvenih usluga. Sprovedena je jednosmerna i dvosmerna analiza osetljivosti. Rezultati. Ukupni troškovi u grupi koja je bila podvrgnuta fakoemulzifikaciji iznosili su 71 008.70 srpskih dinara (RSD), dok su u ECCE grupi oni iznosili 74 340.36 RSD. Istovremeno, fakoemulzifikacija je pokazala višu efikasnost u odnosu na ECCE, 87% i 57% bolesnika bez komplikacija, redom. Na osnovu dobijenih rezultata, fakoemulzifikacija je bila dominantna strategija u poređenju sa ECCE. Analiza osetljivosti pokazala je da su rezultati osetljivi na broj izvršenih intervencija na godišnjem nivou. Zaključak. Fakoemulzifikacija je ekonomski isplativija tehnika operacije katarakte u odnosu na ECCE. Sva ulaganje u opremu i potrošni materijal za fakoemulzifikaciju opravdani su ukoliko je broj izvedenih operacija na godišnjem nivou preko 350.
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