Influence of self-help for uncontrolled arterial hypertension on application for emergency care in St. Petersburg

Objective. To conduct a medical and social analysis of the patients› demand for emergency medical care for uncontrolled arterial hypertension in St. Petersburg and to calculate the expected economic effect. Objectives of the study. 1. To study the structure of patients› visits in connection with increased blood pressure and to assess their five-year survival rate, as well as to identify the most common emergency conditions; 2. To study and assess the prevalence, dynamics of treatments, distribution by gender and age of patients associated with uncontrolled arterial hypertension during 2015–2017; 3. Using neural networks, to predict changes in the number of patients in connection with an increase in blood pressure; 4. Taking into account the previous study, calculate the estimated economic effect of self-help prescription. Materials and methods of research. A retrospective analysis of patients› appeals from St. Petersburg in the period 2015–2017 was carried out. In total, the study included 250413 patients who sought help during this period 388603 times. Outcomes. As a result of the work carried out, the most common emergency conditions were identified, the structure of appeals in connection with uncontrolled arterial hypertension was clarified, and their dynamics and distribution of patients by age and gender were determined. A forecast of changes in the number of patients who sought emergency medical care due to increased blood pressure was carried out. The survival rate of patients was assessed and the estimated economic effect of self-care was calculated. Conclusion. The study showed that in the structure of appeals in connection with an increase in blood pressure in St. Petersburg, the number of calls for uncontrolled hypertension was 94.6%. Appeals on this occasion in 2015–2017 increased by 17.8%, due to repeated and for the first time in this year appeals from elderly, senile and long-lived women. At the same time, 90.8% of patients did not require intensive care and/ or hospitalization. The five-year survival rate of patients seeking help for high blood pressure was high and the probability that he would live five years was more than 0,98 (98%). Prognostic modeling of the number of women living in the district or city has shown that the larger the number of older female patients living in the district or city, the more the number of women seeking help in this regard will increase. The estimated economic effect of the appointment of self-help may amount to 80 026 743,8 rubles per year.

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