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Title:Modelling of the risk factors and chronic diseases that influence the development of serious health complications
Authors:Atanasijević-Kunc, Maja (Author)
Drinovec, Jože (Author)
Ručigaj, Simona (Author)
Mrhar, Aleš (Author)
Files:.pdf Zdravniski_vestnik_2008_Atanasijevic-Kunc_et_al._MODELLING_OF_THE_RISK_FACTORS_AND_CHRONIC_DISEASES_THAT_INFLUENCE_THE_DEVELOPMENT_OF_SE.pdf (1,10 MB)
 
URL http://vestnik.szd.si/index.php/ZdravVest/article/view/492
 
Language:English
Work type:Scientific work (r2)
Typology:1.01 - Original Scientific Article
Organization:MF - Faculty of Medicine
Abstract:Background: Some chronic diseases, like diabetes type 2 and hypertension, and risk factors, such as obesity, hypercholesterolemia, and smoking, are strongly correlated with the potential development of serious health complications that can threaten a patient's life or significantly influence the quality of life, while at the same time representing an enormous economic burden. Such complications include, for example, stroke, coronary heart disease, peripheralarterial vascular disease, end-stage renal disease and congestive heart failure. Methods: For a quantitative evaluation of the mentioned patient groups, the age distribution and an estimation of the treatment expenses a dynamic mathematical model was developed, where special attention was devoted to its structure, as it should enable the sequential construction and representation of different forms of data information. The model was realized in the Matlab program package with the Simulink Toolbox. Conclusions: A dynamic mathematical model is described that enables the observation of patients (in percentage terms) with diabetes type 2 and obesity, as well as those who smoke, have hypercholesterolemia and hypertension and all possible combinations of these problems, related to their age. Taking into account the Slovenian demographic data and annual treatment expenses, we were able to quantitatively evaluate these factors, not only in Slovenia but also in other developed regions where the demographic and economic situations are similar. It is also possible to extend the model to patients with serious complications, also taking into account the population dynamics, which is the goal of the next steps in our investigation. Regarding the presented results, it is estimated that from a group of a million people, those requiring treatment for diabetes type 2 cost as much as € 19.5 millions per year, since the treatment of one patient for one year is € 355. If all the sufferers requiring such treatment were located, as a consequence of more systematic medical examinations, an additional € 16 millions would be needed. In this group of one million people, as many as 40 % are expected to develop hypercholesterolemia, of which 26 % are diagnosed and treated adequately. The annual cost for the treatment of one patient is 313, which means that for a group of a million people the costs would be € 82 millions per year. An additional € 43.5 millions would be needed if all the sufferers with hypercholesterolemia were treated. Another chronic disease is hypertension. The annual cost for treating one patient is estimated to be € 271, and so for a group of a million people the treatment costs would be € 69.5 millions. If this were extended to include so far undiscovered sufferers with this chronic disease an additional € 14.5 millions would be needed.
Keywords:modelling, simulation, diabetes type 2, obesity, smoking, hypercholesterolemia, hypertension
Year of publishing:2008
Number of pages:str. 487-498
Numbering:št. 8, Letn. 77
ISSN:1318-0347
UDC:61
ISSN on article:1318-0347
COBISS_ID:24724697 Link is opened in a new window
NUK URN:URN:SI:UM:DK:K9IUCESX
License:CC BY-NC 4.0
This work is available under this license: Creative Commons Attribution Non-Commercial 4.0 International
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Record is a part of a journal

Title:Zdravniški vestnik
Publisher:Slovensko zdravniško društvo
ISSN:1318-0347
COBISS.SI-ID:32893696 New window

Secondary language

Language:Slovenian
Title:Modeliranje dejavnikov tveganja in kroničnih bolezni, ki vplivajo na razvoj hujših zdravstvenih zapletov
Abstract:Izhodišča: Nekatere kronične bolezni, kot so diabetes tipa 2 in hipertenzija ter dejavniki tveganja, kamor uvrščamo debelost, dislipidemijo in kajenje, so tesno povezani z razvojem hudih zdravstvenih zapletov, ki lahko ogrozijo pacientovo življenje oz. bistveno vplivajo na kvaliteto življenja, hkrati pa pomenijo izjemno veliko ekonomsko breme. Med tovrstne zaplete sodijo npr. možganska kap, koronarna srčna bolezen, srčno popuščanje, periferna arterijska žilna bolezen pa tudi končna odpoved ledvic. Metode: Da bi lahko tudi kvantitativno ovrednotili razširjenost in starostno porazdelitev posameznih skupin pacientov ter stroškov zdravljenja, smo razvili dinamični matematični model, pri čemer je bila posebna pozornost posvečena njegovi strukturi, ki omogoča postopen razvoj ter upoštevanje in prikaz informacij različnih oblik. Model je realiziran v programskem paketu Matlab z orodjem Simulink. Zaključki: Opisani dinamični matematični model razvoja diabetesa tipa 2, debelosti, kajenja, dislipidemije in hipertenzije omogoča opazovanje opisanih bolezni in dejavnikov tveganja relativno, v procentih, glede na starost pacientov, pri čemer smo pri modeliranju upoštevali tudi vse možne kombinacije omenjenih skupin pacientov. Dodajanje informacij, povezanih z demografskimi razmerami v Sloveniji ter letno ceno zdravljenja posameznih bolezni, je omogočilo tudi kvantitativno vrednotenje razmer, in sicer tako v Sloveniji kot tudi v razvitih deželah, kjer sta demografska struktura prebivalstva in ekonomski razvoj primerljiva. Možno pa je tudi dopolnjevanje modela z vključitvijo hujših zdravstvenih zapletov in napovedmi spreminjanja števila prebivalstva, kar bo predmet naših nadaljnjih raziskav. Na osnovi predstavljenih rezultatov modeliranja je mogoče pričakovati, da je v populaciji z milijon prebivalci za letno zdravljenje diabetesa 2 namenjeno 19,5 milijona € , oz. 355 € na pacienta, še dodatnih 16 milijonov pa bi potrebovali, če bi s sistematskimi pregledi odkrili vse paciente. V isti skupini prebivalcev lahko pričakujemo kar 40 % pacientov z dislipedimijo, med katerimi je odkritih in ustrezno zdravljenih 26 %. Ker znaša letna cena zdravljenja te kronične bolezni na pacienta 313 €, je na milijon prebivalcev za zdravljenje dislipidemije potrebnih 82 milijonov, še dodatnih 43,5 pa bi potrebovali, če bi bili zdravljeni vsi pacienti. Zelo razširjena kronična bolezen je tudi hipertenzija. Letno zdravljenje enega pacienta znaša 271 € , kar pomeni 69,5 milijona € na milijon prebivalcev, še dodatnih 14,5 milijona pa bi jih potrebovali, če bi bili z bolj sistematičnimi pregledi odkriti vsi pacienti. Za zdravljenje omenjenih kroničnih bolezni je torej potrebnih v Sloveniji preko 340 milijonov €, še dodatnih 148 pa bi jih morali nameniti zaenkrat neodkritim pacientom. Poznano je, da so hudi zdravstveni zapleti med ustrezno zdravljenimi kroničnimi bolniki izrazito redkejši, tako da je z etičnega stališča odkrivanje tovrstnih pacientov seveda upravičeno. Z nadaljnjim razvojem modela pa bomo skušali ovrednotiti tudi ekonomske prihranke, ki bi nastopili z zdravljenjem vseh obravnavanih kroničnih bolnikov zaradi zmanjšanja hudih obolenj.
Keywords:modeliranje, simulacija, diabetes tipa 2, debelost, kajenje, dislipidemija, hipertenzija


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