A cukorbetegség szemészeti szövődményeinek modellalapú költségterhe Magyarországon

Tóth, Gábor; Nagy, Zoltán Zsolt; Németh, János

doi:10.1556/650.2021.32031

Cited by 7 publications

(4 citation statements)

References 27 publications

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“…In Hungary, good practices were consciously defined, collected, and disseminated in the frame of an EU funded project focusing on patient safety and effectiveness [ 20 , 21 ]. It is also mentioned in the context of the effectiveness of special treatments for select diseases in ophthalmology [ 22 ]. In Ukraine, similarly to Poland and Hungary, there is no fixed term or definition of “good practice” in legal acts pertaining to financing health care services.…”

Section: Discussionmentioning

confidence: 99%

How much can we learn from each other? Polish and Hungarian good practices in financing ophthalmology care as a proposal for implementation in Ukraine

Więckowska,

Byszek,

Rękas

et al. 2024

PLoS ONE

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Objectives The article aims to compare payment schemes for cataract, glaucoma, vitrectomy, cornea transplantations, DME, and AMD across Hungary, Poland, and Ukraine, and to identify implementable practices in Ukraine within the context of ongoing healthcare reforms. Methods Researchers used mixed-method research–with legal documents and data analysis on utilisation of ophthalmology services between 2010 and 2019 and in-depth semi structured interviews with fifteen health experts from Hungary, Poland, and Ukraine. Interviewees, five from each country, were representatives from healthcare providers and payers with at least 10 years’ experience in ophthalmology care and knowledge about financing schemes in each country of residence. Results We identified significant differences in healthcare delivery and financing of ophthalmology services between Hungary and Poland, despite both countries rely on Diagnosis-Related Group (DRG) based systems for hospital care. Good practices for financing specific eye treatments like cataract, glaucoma, age-related macular degeneration (AMD), diabetic macular edema (DME), cornea transplantations, and vitrectomy are identified. The financing scheme, including financial products and incentives, can influence the volume of treatments. Access to ophthalmic care is a key concern, with differences in treatment schemes between Hungary (ambulatory care) and Poland (hospital care), leading to higher costs and the need for centralization of complex procedures like cornea transplantations. Conclusions The article highlights the importance of incentivizing quality improvements and removing financial barriers in Poland, while Hungary should focus on continuous monitoring of treatment methods and flexibility in reimbursement. For Ukraine, the research findings are significant due to ongoing healthcare reform, and the country seeks optimal practices while considering the experiences of other countries.

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Section: Discussionmentioning

confidence: 99%

How much can we learn from each other? Polish and Hungarian good practices in financing ophthalmology care as a proposal for implementation in Ukraine

Więckowska,

Byszek,

Rękas

et al. 2024

PLoS ONE

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“…DR causes irreversible damage to visual function and brings a heavy burden to society [ 39 ]. Preventing DR has become the top priority in the treatment of blindness.…”

Section: Discussionmentioning

confidence: 99%

Discovery of Therapeutic Candidates for Diabetic Retinopathy Based on Molecular Switch Analysis: Application of a Systematic Process

Ren

Liu

et al. 2022

Oxidative Medicine and Cellular Longevity

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The pathogenesis of diabetic retinopathy (DR) is complicated, and there is no effective drug. Oxidative stress-induced human retinal microvascular endothelial cells (HRMECs) injury is one of the pathogenic factors for DR. Molecular switches are considered high-risk targets in disease progression. Identification of molecular switch is crucial to interpret the pathogenesis of disease and screen effective ingredients. In this study, a systematic process was executed to discover therapeutic candidates for DR based on HRMECs injury. First of all, the molecular mechanism of HRMECs oxidative stress injury was revealed by transcriptomics and network pharmacology. We found that oxidative stress was one of the pivotal pathogenic factors, which interfered with vascular system development, inflammation, cell adhesion, and cytoskeleton damaged HRMECs through crosstalk. Then, network topology analysis was used to recognize molecular switches. The results indicated that the Keap1-Nrf2-ARE signaling pathway was the molecular switch in HRMECs oxidative stress injury. On this basis, the HEK293-ARE overexpression cell line was applied to obtain 18 active traditional Chinese medicine (TCM) ingredients. Furthermore, andrographolide, one of the 18 candidates, was applied in the HRMECs oxidative stress model to evaluate the accuracy of the systematic process. The efficacy evaluation results showed that andrographolide could regulate oxidative stress, vascular system development, inflammation, adhesion, and skeleton tissue to inhibit HRMECs injury cooperatively. And its mechanism was related to the Nrf2 signaling pathway. Overall, our data suggest that the Nrf2 signaling pathway is the molecular switch in the HRMECs oxidative stress injury. 18 potential Nrf2 agonists are likely to be promising DR candidates.

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“…Ismert ugyanis, hogy a rendszeres időközönként elvégzett szemészeti ellenőrzésekkel és a megfelelő időben történő kezeléssel a cukorbetegség következtében kialakuló vakság megelőzhető lenne [31,32]. A hatékony prevenció jelentős költségcsökkenéssel is járna, hiszen a cukorbetegek szemészeti ellátásában a súlyos esetek ellátása a költségek 86%-áért felelős [33,34].…”

Section: Megbeszélésunclassified

Hátsószegmens-betegségek okozta látásromlás és vakság Magyarországon az 50 évnél idősebb korú lakosság körében

Tóth

Szabó

Sándor

et al. 2022

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Összefoglaló. Bevezetés: A fejlett országok körében a hátsószegmens-betegségek számítanak a vakság és a gyengénlátás leggyakoribb okának az időskorú lakosság körében. Célkitűzés: Tanulmányunk célja a hátsószegmens-betegségek okozta látásromlás és vakság prevalenciájának meghatározása az 50 éves és annál idősebb korú lakosság körében Magyarországon. Módszer: A Központi Statisztikai Hivatal által kijelölt 105 lakókörzetben, az Elkerülhető Vakság Gyors Felmérése (Rapid Assessment of Avoidable Blindness; RAAB) metodika segítségével végeztük a vizsgálatokat. Minden résztvevőnél direkt szemtükörrel szemvizsgálatot végeztünk. A látóélességet egyszerűsített Snellen-tábla segítségével, stenop lyukkal, illetve a nélkül vizsgáltuk. A cukorbeteg résztvevőkön pupillatágítást és szemfenéki vizsgálatot végeztünk indirekt binokuláris oftalmoszkóppal. Eredmények: Összességében 3675 alkalmas résztvevőből 3523 (95,9%) személyt vizsgáltunk, akik között a hátsószegmens-betegségek következtében kialakult kétoldali vakság és súlyos látásromlás prevalenciája 0,7% és 0,2% volt. A hátsó szegmens betegségei miatt kialakult összes látásromlás leggyakoribb okai gyakorisági sorrendben (prevalenciaértékkel) a következők voltak: öregkori maculadegeneratio (1,419%), glaucoma (0,397%), diabeteses retinopathia (0,341%) és rhegmatogen ideghártya-leválás (0,198%). A hátsószegmens-betegség okozta vakság leggyakoribb okai az öregkori maculadegeneratio (37,5%), a glaucoma (16,7%), a diabeteses retinopathia (8,3%), a nagyfokú myopia (8,3%), a rhegmatogen retinaleválás (8,3%) és a retinitis pigmentosa (8,3%) voltak. Következtetés: Hazánkban a súlyos látásromláshoz és vaksághoz vezető hátsószegmens-betegségek előfordulási gyakorisága más, korábban RAAB-felmérést végzett országokéhoz képest alacsonyabb, az egyes kórképek gyakorisági sorrendje pedig a fejlett országokéhoz hasonló. Az öregkori maculadegeneratiós, glaucomás, cukorbeteg és patológiás myop páciensek folyamatosan növekvő száma miatt javítani kellene a szemészeti ellátás hozzáférhetőségén és modernizálni a finanszírozását. Orv Hetil. 2022; 163(16): 624–630. Summary. Introduction: Posterior segment diseases are the most common causes of blindness and visual impairment in developed countries among people aged 50 years and older in Hungary. Objective: The purpose of this study was to estimate the prevalence of visual impairment and blindness caused by posterior segment diseases in the population aged 50 years and older in Hungary. Method: 105 census enumeration units were randomly selected with a probability proportional to size by the Hungarian Central Statistical Office. The standardised Rapid Assessment of Avoidable Blindness (RAAB) method was used. Participants underwent eye examination with a direct ophthalmoscope. Participants underwent visual acuity testing with a Snellen tumbling E-chart with or without a pinhole. Dilated fundus examination was performed in diabetic participants using an indirect binocular ophthalmoscope. Results: In total, 3523 (95.9%) out of 3675 eligible people were examined, of whom the prevalence of bilateral blindness and severe visual impairment was 0.7% and 0.2%, respectively. The most common causes of visual impairment caused by posterior segment diseases were age-related macular degeneration (1.419%), glaucoma (0.397%), diabetic retinopathy (0.341%) and rhegmatogenous retinal detachment (0.198%). The most common causes of blindness caused by posterior segment diseases were age-related macular degeneration (37.5%), glaucoma (16.7%), diabetic retinopathy (8.3%), high myopia (8.3%), rhegmatogenous retinal detachment (8.3%) and retinitis pigmentosa (8.3%). Conclusion: Prevalence of severe visual impairment and blindness caused by posterior segment diseases was lower compared to results of RAAB surveys in other countries. The frequency order of different posterior segment diseases was in line with developed countries. Availability of eye care should be improved and financing should be modernized due to the continuously increasing number of patients with age-related macular degeneration, glaucoma, diabetes and pathologic myopia. Orv Hetil. 2022; 163(16): 624–630.

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A cukorbetegség szemészeti szövődményeinek modellalapú költségterhe Magyarországon

Cited by 7 publications

References 27 publications

How much can we learn from each other? Polish and Hungarian good practices in financing ophthalmology care as a proposal for implementation in Ukraine

How much can we learn from each other? Polish and Hungarian good practices in financing ophthalmology care as a proposal for implementation in Ukraine

Discovery of Therapeutic Candidates for Diabetic Retinopathy Based on Molecular Switch Analysis: Application of a Systematic Process

Hátsószegmens-betegségek okozta látásromlás és vakság Magyarországon az 50 évnél idősebb korú lakosság körében

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