Organizational and financial aspects of choosing intraocular lenses in cataract surgery in a value-based health care system.
Authors:   State Autonomous Health Institution «The Republican Clinical Ophthalmic Hospital of Ministry of Health of the Republic of Tatarstan named after Professor E. V. Adamyuk, Zigangareeva G. G. ,   Kazan State Medical Academy – Branch Campus of the FSBEIFPE RMACPE MOH Russia, Koroleva O. I. ,   State Autonomous Health Institution «The Republican Clinical Ophthalmic Hospital of Ministry of Health of the Republic of Tatarstan named after Professor E. V. Adamyuk, Khusainova D. K. ,   State Autonomous Health Institution «The Republican Clinical Ophthalmic Hospital of Ministry of Health of the Republic of Tatarstan named after Professor E. V. Adamyuk
Published: September 2024

Relevance. In modern conditions, value-based healthcare provides for the provision by medical organizations of medical care of appropriate quality with mandatory control of its cost. Treatment outcomes that are important to the patient become no less significant than clinical performance indicators and payment for medical services, regardless of the profile of medical care. The gradual change in paradigms of healthcare systems from a paternalistic to a person-centric model required changes in organizational, legislative and financial approaches when introducing health-saving healthcare technologies. Purpose of the study: analysis of the current organizational, legal, financial and clinical models of surgical treatment of patients with age-related cataracts, astigmatism and development of proposals for the implementation of the patient’s right to choose intraocular lenses, taking into account his modern expectations from the results of treatment. Materials and methods. Statistical and analytical methods were used (content analysis methods, expert assessment methods, analysis and synthesis methods). Results. An analysis of the legislation in organizing the provision and financing of medical care to the adult population in the field of ophthalmology is presented, and state guarantees for the use of medical products – types of intraocular lenses implanted into the human body for the surgical treatment of senile cataracts and astigmatism – are considered. Clinical models of the disease are systematized, taking into account the frequency and frequency of provision of medical services and the list of medical devices implanted into the human body, professional, medico-economic, medico-legal and reputational risks are described when exercising the patient’s right to choose intraocular lenses in the treatment of ophthalmological pathology. Proposals have been developed to change clinical recommendations, standards of medical care for senile cataracts and astigmatism, and improve payment for ophthalmological care. Conclusions. The transition to value-based healthcare requires the consolidation of the efforts of all structures of the healthcare industry to achieve the best results in the treatment of ophthalmic diseases and increase the clinical effectiveness associated with the choice of intraocular lenses in the surgical treatment of adults in the field of ophthalmology.