All articles by Chuprov A. D.
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2023 № 7 Review of the regulatory framework regarding the use of multifocal IOLs for cataract surgery.
Considering the increasing requirements for the quality of postoperative vision, the number of requests from patients for the implantation of a multifocal IOL is increasing, which makes it relevant to analyze the existing regulatory framework for the possibility and obligation to use this medical device in the provision of specialized medical care – surgical treatment of cataract within the framework of the state guarantees program. An analysis of the current regulatory framework showed that the existing regulatory framework allows the use of multifocal IOLs in the provision of medical services under the state guarantees program, however, it does not give the patient the right to choose, and makes considering the patient’s desire to implant this particular type of medical device is not mandatory when planning
surgery. Considering the requirements of mandatory informed voluntary consent when receiving a medical service, the patient must be informed about the implantation or refusal to implant this type of medical device when providing him with specialized medical care. Most of the analyzed medical devices – IOLs with multifocal properties – are registered in the Russian Federation as “Intraocular lens for the posterior chamber of the eye, pseudophakic”, and not “Intraocular lens for the posterior chamber of the eye, pseudophakic, with increased depth of focus”. There is both a clinical need for changes (Clinical guidelines), and an organizational need to identify a group of operations, including with the application of additional coefficients to the tariff as part of the payment for medical services included in the program of state guarantees. -
2017 № 6 Regulatory framework for providing high-technology ophthalmological medical care under outpatient treatment
The article analyzes the existing legal basis for providing high-technology ophthalmological medical care through a systematic review of regulatory enactments that directly regulate this type of activity (14 regulatory enactments, including 2 federal laws).
High-technology medical care is a separately licensed type of medical activity carried out by approved federal or regional medical organizations, financed by subsidy or directly from federal budget, provided for approved types of medical care in a hospital. The source of funding for healthcare determines essential conditions. The existing legal framework creates significant restrictions for providing high-technology ophthalmological medical care under outpatient treatment in the case of healthcare covered by Compulsory Health Insurance or an appropriate budget. The article outlines the ways of solving this problem proposed by the authors, including for a medical institution, without violating the current legislation. Healthcare covered by other sources of funding can be provided in any conditions, including outpatient -
2020 № 1 Assessment of the demand of population with cataract for specialized medical care
The Study of the adequate demand of population in specialized medical care is one of the problematic issues in the process of planning of medical care. The aim of the study was to develop an indicator to assess the demand of population with cataract for specialized medical care. Information on the research topic was collected from books and electronic sources, including Internet sites in order to achieve the aim. A comparative analysis of ophthalmological data from the official statistical reporting forms (№ 12, № 14) of Orenburg, Samara, Penza and Perm regions was performed. As part of the study, significant spread in the values of indicators of general and primary morbidity of the population with eye diseases, both within the region and between regions, was defined. The values of the indicator for assessing the demand of population for specialized medical care for cataracts were obtained.
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2019 № 3 Cost performance of the selective laser trabeculoplasty for patients with primary open-angle glaucoma
Primary open-angle glaucoma, as the most common form of glaucoma, is an important medico-social problem. Selective laser trabeculoplasty is an effective and safe method of treatment of primary open-angle glaucoma. The purpose of this work was to estimate the cost performance of the treatment of patients with primary open-angle glaucoma using selective laser trabeculoplasty and their stagewise dynamics during the treatment. The analysis of 250 patients (338 eyes) with primary open-angle glaucoma, operated using selective laser trabeculoplasty in the Orenburg branch of S. Fyodorov Eye Microsurgery Federal State Institution of the Ministry of Health of the Russian Federation, was carried out. The patients are from 42 to 86 years old, of which 118 are women (47.2%) and 132 are men (52.8%), all of them being residents of the Orenburg region. Intraocular pressure before selective laser trabeculoplasty ranged from 20 to 30 mm Hg. All the patients attended standard ophthalmological examination before the operation. Selective laser trabeculoplasty was performed on the apparatus Quantel Medical Optimis with Solutis attachment at standard parameters. During the postoperative period, nonsteroidal anti-inflammatory drugs were prescribed to the patients for 7 days. The follow-up period after selective laser trabeculoplasty: 1 day; 1, 3, 6, 12 months. The linear method and cluster analysis were used as mathematical methods; the processing was carried out using STATISTICA 10 software package. Statistical analysis was performed on subsamples drawn on the basis of qualitative characteristics: gender code; age code; code “working/not working”; disease severity code; OD diagnosis code and OS diagnosis code. All 250 patients were divided into 5 clusters with the help of cluster analysis applied to the characteristics listed above. Clusters, in which patients have the lowest and the highest average expenditures for antihypertensive drugs for the entire period of treatment, were identified. The results of cluster analysis can be the basis for constructing a model of the average estimated expenses of patients with primary open-angle glaucoma operated with selective laser trabeculoplasty. Determining the ratio of material expenditures and the result of treatment allows to effectively plan ophthalmological care for patients with primary open-angle glaucoma.