COST ASSESSMENT OF GOUT: YOUNG PATIENTS AGAINST ELDERLY

OBJECTIVES: Gout has become is significant clinical problem in Russia, requiring costly to treat. Gout has many comorbid diseases: hypertension, chronic renal disease, coronary heart disease, heart failure, diabetes, kidney stones, which significantly increases the cost of treatment. When building a cost model based on the standards, which lists the medical intervention with the frequency of their use for diseases with high comorbidity is necessary to use the correction factor reducing margins (RM), which empirically has been calculated by RSPOR in 2007. The aim of the study was the prognostic assessment of patients with the cost of doing with gout during the year, taking into account polymorbidity and RM. METHODS: Were included 200 patients with gout, composed comorbid profile and matrix for all combinations of diseases, frequency combinations. Calculated the direct costs of treatment of gout and related diseases for each existing combination of comorbid pathology taking into account hospitalization rate for "young" and "old" populations and the RM (the value determined by the number of diseases, recorded in the preparation of models). RESULTS: In group A(age 57.9±11.3,N=150) was observed 2 comorbid disease to a patient, in the group B(age of 73.3±4.4,N=50) - 4. Elderly hospitalized significantly more often "young" - 1.2 hospitalizations per year, versus 0.7(p=0.001). Direct projected costs of treating comorbid diseases 5 on 1 patient in the course of the year in the summation indices standards amounted to 21363$, and in view of the RM-12818$. Average direct costs for the year gout treatment in 1 patient out of a population of "young" amounted to 1315$ per year and 7201$ in view of comorbid diseases and the RM, in the "old" group, respectively 2033$ and 14982$. CONCLUSIONS: The marginality factor helps to make more accurate forecast of the cost of comorbid chronic diseases, the frequency of which increases significantly in older patients.