Socioeconomic benefits from adequate correction of iron deficiency in pregnant women
The analysis of the economic aspects of medical technologies used to resolve iron deficiency/anemia in pregnant/parturient/puerperal women is aimed at identifying the most effective tactics to improve healthcare quality in obstetrics and to save health resources.Kurilovich E.O., Volkova O.I., Fedorova T.A., Golubtsov V.V., Popovich L.D., Andreeva M.D., Barkovskaya N.A., Shmakov R.G., Akhidzhak A.N., Khamidulina K.G.
Objective: To assess the potential country and applied health benefits in the transition from the established practice to the optimized practice in the correction of iron deficiency/iron deficiency anemia in pregnant women.
Materials and methods: Socioeconomic damage and its monetary expression from the outcomes of pregnancies in the presence of iron deficiency/iron deficiency anemia were assessed, by estimating the years of life lost/saved (the Global Burden of Disease concept). Potentially preventable damage and applied health benefits were calculated within the framework of a simulation model that assumes timely and adequate therapeutic correction of prenatal iron deficiency/anemia as a component of a package of measures for patient blood management, by taking into account the likely outcomes when changing the treatment policy. The material to be analyzed was data from the medical records of 292 pregnant women diagnosed with iron deficiency anemia.
Results: When patient blood management was comprehensively implemented in obstetrics, the socioeconomic damage could potentially decrease by 5.6 times due to a reduction in the monetary equivalent of specific losses during spontaneous labor (by 94.6%) and during cesarean section delivery (by 58.6%). The positive impact of timely and adequate correction of iron deficiency in pregnant women on the financial-and-economic component of healthcare was expressed in the annual savings of more than 2.5 billion rubles due to the reduction in the excess days of maternity hospital stay in the puerperal women and to the exclusion of transfusions of 72,473 liters of blood products.
Conclusion: Timely diagnosis, individual selection, and an adequate procedure for administering iron-containing agents will provide for a decrease in social losses.
Keywords
iron deficiency
anemia during pregnancy
socioeconomic damage
applied healthcare economics
patient blood management
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Received 18.08.2021
Accepted 17.09.2021
About the Authors
Ekaterina O. Kurilovich, Expert, Institute of Health Economics, National Research University Higher School of Economics, +7(962)942-15-61, k-ekaterina-o@mail.ru, https://orcid.org/0000-0003-0226-2461, 109074, Russia, Moscow, Slavyanskaya sqr., 4 build. 2.Olga I. Volkova, Expert, Institute of Health Economics, National Research University Higher School of Economics, +7(903)525-45-23, ovolkova08@mail.ru, https://orcid.org/0000-0002-5633-0776, 109074, Russia, Moscow, Slavyanskaya sqr., 4 build. 2.
Tatiana A. Fedorova, Dr. Med. Sci., Professor, Head of Transfusional Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, +7(495)438-71-35, t_fyodorova@oparina4.ru, https://orcid.org/0000-0001-6714-6344, 117997, Russia, Moscow , Ас. Oparinа str., 4.
Vladislav V. Golubtsov, Dr. Med. Sci., Professor of the Department of Anesthesiology, Reanimatology and Transfusiology, Kuban State Medical University, Ministry of Health of Russia, +7(861)222-01-59, +7(928)662-83-62, golubtsovv@mail.ru, https://orcid.org/0000-0002-6054-9404, 350063, Russia, Krasnodar, Mitrofana Sedina str., 4.
Larisa D. Popovich, PhD (Bio), Director, Institute of Health Economics, National Research University Higher School of Economics, +7(926)143-24-43, ldpopovich@hse.ru, https://orcid.org/0000-0002-4566-8704, 109074, Russia, Moscow, Slavyanskaya sqr., 4 build. 2.
Margarita D. Andreeva, Dr. Med. Sci., Professor of the Department of Obstetrics, Gynecology and Perinatology of the FPK and the Teaching Staff , Kuban State Medical University, Ministry of Health of Russia, +7(918)388-61-10, andreeva_md@mail.ru, https://orcid.org/0000-0002-6524-3965, 350063, Russia, Krasnodar, Mitrofana Sedina str., 4.
Natalya A. Barkovskaya, PhD, Head of Anaesthesiology and Reanimation Department, Dzerzhinsk Perinatal Center; Assistant, Department of Obstetrics and Gynaecology, Faculty of Additional Professional Education, Privolzhsky Research Medical University, Ministry of Health of the Russian Federation, +7(910)144-17-20, bar-natalya@mail.ru, https://orcid.org/0000-0002-2360-0805, 603950, Russia, Nizhny Novgorod, Minin and Pozharsky Sqr., 10/1.
Roman G. Shmakov, Dr. Med. Sci., Professor, Director of the Institute of Obstetrics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of Russian Federation, +7(495)438-24-89, r_shmakov@oparina4.ru, 117997, Russia, Moscow, Ас. Oparinа str., 4.
Asya N. Ahidzhak, Head of the Maternity Department of the Perinatal Center, Regional Clinical Hospital No. 2, Ministry of Health of the Krasnodar Region, +7(918)353-92-53, ahidzhak.asya@mail.ru, https://orcid.org/0000-0001-9677-1966, 350012, Russia, Krasnodar, Red Partizan str., 6/2.
Ksenia G. Khamidulina, PhD, Researcher of the Department of Extracorporeal Methods of Treatment and Detoxification, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(495)438-71-35, k_bykova@oparina4.ru, https://orcid.org/ 0000-0001-5394-1910, 117997, Russia, Moscow, Ac. Oparina str., 4.
Authors’ contributions: Kurilovich E.O., Volkova O.I., Fedorova T.A., Popovich L.D., Shmakov R.G. – development of the design of the investigation; writing and editing the text of the manuscript; Golubtsov V.V., Andreeva M.D., Barkovskaya N.A. – data obtaining for analysis; analysis of the findings; tabulation of the results; Akhidzhak A.N., Khamidulina K.G. – review of publications on the topic of the article; statistical analysis of the findings; execution of the article for publication.
Conflicts of interest: The authors declare that there are no possible conflicts of interest.
Funding: This investigation has not been sponsored.
For citation: Kurilovich E.O., Volkova O.I., Fedorova T.A., Golubtsov V.V., Popovich L.D., Andreeva M.D., Barkovskaya N.A., Shmakov R.G., Akhidzhak A.N., Khamidulina K.G. Socioeconomic benefits from adequate correction of iron deficiency in pregnant women.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 9: 212-220 (in Russian)
https://dx.doi.org/10.18565/aig.2021.9.212-220
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