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SYSTEMS ANALYSIS IN PRACTICAL PUBLIC HEALTH ON THE EXAMPLE OF
MANAGING PATIENTS WITH CHEMICAL EYE BURNS
Maksudova L.M.
1
Ibadova G.A.
2
Rizaeva M.A.
3
1
Doctor of Medical Sciences, Associate Professor, Department of Ophthalmology, Center
for Professional Development of Healthcare Workers under the Ministry of Health of
the Republic of Uzbekistan. Email:
2
Doctor of Medical Sciences, Professor, Department of Infectious, Children's Infectious
and Parasitic Diseases, Center for Professional Development of Healthcare Workers
under the Ministry of Health of the Republic of Uzbekistan. Email:
3
Republican Clinical Ophthalmological Hospital - ophthalmologist Email:
https://doi.org/10.5281/zenodo.12800204
Relevance.
Systems analysis is associated with a complex set of elements interacting
with each other. The result of a system analysis is a comparative description of alternative
options in order to select the most optimal one, in terms of all compared parameters, and at
the same time, the least expensive one, which is especially important in the context of
insurance medicine. During the period of capitalization of the country, and especially during
the period of transition to insurance medicine, the calculation of the economic efficiency of
the introduction of new methods of treatment and the calculation of the cost of treatment in
general is a very important socio-economic factor.
Purpose:
To optimize approaches to the treatment of patients with chemical eye burns
based on an individualized approach to the treatment management, therapy, prediction of
complications and outcomes of chemical eye burns.
Methods and techniques.
The following categories were identified as alternative
options (A): A1 - standardized approach, without individualization of patients with their
management according to the National Protocol as the lesion manifests itself and in the
dynamics of the development of complications of the process; A2 - individualized approach
based on the use of genetic analysis based on HLA testing; A3 - individualized approach based
on the determination of FA in patients. The next step was the selection of criteria (K), by
which the effectiveness of each of the proposed alternative approaches and its
implementation will be evaluated: K - the quality of care for patients. This criterion was
evaluated according to the following indicators: K1 - the duration of the main manifestations
of the disease (in weeks); K2 - the effectiveness of the therapy (the frequency of complications
and relapses); K3 - the degree of restoration of the organ of vision after a chemical burn of the
eyes (according to visual acuity);
When choosing criteria, we limited ourselves to the most significant of them, which can
show the effectiveness of each of the selected alternative approaches to managing patients
with chemical eye burns.
Results.
The next stage of the analysis was to evaluate the effectiveness of each of the
compared approaches to managing patients based on the possibilities of their implementation
and the greatest economic efficiency. In this regard, in the work, scaling was carried out
according to the specified criteria, with an assessment of their economic significance and
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limitations in their application. According to the developed criteria K (K1, K2, K3), probability
scales (S) were formed. Probabilities were assessed on a scale from 0.0 to 1.0. In this regard,
the developed scales for assessing the most optimal approach to the management of patients
with chemical eye burns present options from 0.0 to 1.0, taking into account the proposed
option with the definition of FA and each of the alternative methods of comparison: a
standardized approach and individualized testing for HLA histocompatibility ( A3, A1 and A2
respectively). At the next stage, we calculated the probabilities according to the specified
criteria for each of the alternative options. The probabilities (S) were calculated according to
the following formula: Ai = Σ
in
× Si / n × (1-R
ij
)
According to systems analysis the larger the value of S, the more effective the proposed
method for solving the problem. Based on the foregoing, alternatives A2 and A3 - an
individualized approach to therapy are more preferable compared to the standardized
method of managing patients with a chemical eye burn SA2 = 0.83 > SA1 = 0.43; SA3 = 0.83 >
SA1 = 0.43. And taking into account the fact that the approach to managing patients with
chemical burns of the eyes with their individualization using the method based on HLA testing
is more costly (from 500,000 UZ soums according to the tariff) than the method of
determining FA we propose (87,000 UZ soums according to the tariff), then despite their
similar efficacy, an individualized approach based on testing patients for their acetylatory
status should be used.
Conclusion.
Thus, based on the results of calculating the economic efficiency, as well as
using a systemic morphological analysis of alternative options, it was found that the use of an
individualized approach to the management of patients with chemical eye burns by
determining their acetylation phenotype can not only reduce the economic costs of treating
such patients, but also improve the quality of care for people with chemical eye burns by
reducing the frequency of relapses and complications of the disease, the length of stay of
patients in the hospital and the best restoration of the functional state of the organ of vision.
References.
According to the results of a systematic morphological analysis of
alternative options, it was found that the application of an individualized approach to the
treatment management of patients with chemical eye burns by determining their acetylation
phenotype can not only reduce the economic costs of treating such patients, but also improve
the quality of care for people with chemical eye burns, by reducing the frequency of relapses
and complications of the disease, the length of stay of patients in the hospital and the best
restoration of the functional state of the organ of vision.
