DOI: https://doi.org/10.22141/2306-2436.9.2.2020.205210

Determination of frequency dispensary examinations of young people with subclinical hypothyroidism by using of a formalized model

O.G. Shekera, P.M. Yablonsky, K.M. Kukharchuk

Abstract


Background. Today, there are practical recommendations for the frequency of in-depth medical (dispensary) examinations of patients with pathology of the thyroid gland (TG), in particular subclinical hypothyroidism (hereinafter - SCH). Such recommendations do not allow to quantify the effect of periodicity on the effectiveness of in-depth medical examinations. The article substantiates the periodicity of dispensary examinations ­using mathematical modeling methods. Endocrinology patients are among those patients who must have in-depth medical examinations. Today, there are some practical recommendations for the frequency of in-depth medical examinations, based on clinical considerations. At the same time, such recommendations do not allow to quantify the impact of periodicity on the effectiveness of in-depth medical examinations. The purpose was substantiation of the frequency of in-depth medical examinations to ensure the maximum possible working capacity of young people with SCH, taking into account the characteristics of the health care system, the frequency of requests for medical care, duration of treatment and more. Materials and methods. The method of mathematical modeling and the method of system and process analysis were used. Results. According to the research program, modern mathematical models that can be used to describe the real system of health care are studied and analyzed. In consideration of the peculiarities of the dispensary system of medical care (its formalized modeling) for young people with SCH, the following main considerations are taken into account: 1) health care is carried out in the form of mandatory in-depth medical examinations after some time along with the possibility of patients independently seeking medical care at any time between in-depth medical examinations; 2) patients in the interval between in-depth medical examinations do not always seek health care for various reasons; 3) there are a number of erroneous requests for medical care from patients who do not need it; 4) one of the main factors that determines the amount of both treatment and in-depth medical examinations is the patients’ incidence rate; 5) it is important to determine the frequency of in-depth medical examinations is the average interval between the patients’ diseases; 6) the real level of quality of medical diagnostics, namely - the timeliness and accuracy of diagnosis in the Centers of primary health care (family medicine clinics), as well as in the hospital; 7) the time spent on restoring the patients' working capacity, as well as on examinations when the patients applying for medical care and during in-depth medical examinations; 8) most of these indicators are random. The article proposes a formalized model of patient care and shows different options for the trajectory of the random process for the model. Conclusions. The obtained results enable ge­neral practitioners - family physicians to optimize the organization of medical care for endocrinological patients by predicting the level of efficiency of both one patient and a group of patients.


Keywords


mathematical modeling; diseases of the endocrine system; young people; medical examination; family doctor

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