Health care for patients suffered from hyperparathyroidism: data from the Federal Compulsory Medical Insurance Fund

Primary hyperparathyroidism (PHPT) is a frequent endocrine disease caused by malignant transformation of one or more parathyroid glands, manifested by an increase in the concentration of parathyroid hormone (PTH), as well as high normal or elevated blood calcium concentrations. The true prevalence of this pathology in Russia is unknown, mainly due to the insufficient coverage of the population with calcemia examination. The number of patients with PHPT receiving surgical treatment is also unknown. Objective. To evaluate the primary incidence of primary hyperparathyroidism, as well as the coverage of patients with key laboratory tests for this disease, consultations of specialists and surgical treatment in the Russian Federation in the frame of the system of compulsory medical insurance (CMI). Materials and methods. A retrospective analysis of data from the Federal Fund of CMI (FCMI) and Territorial Funds of CMI (TFCMI) for 2017—2023 period, collected on the basis of accepted invoices considering the results of medical and economic control, was carried out. Results. In 2023, the mean number of performed investigations of the level of total calcium, ionized and PTH in 57 constituent entities of the Russian Federation available for analysis amounted to 575, 48 and 70 studies per 100 000 population, respectively. Primary incidence of PHPT in Russia — 2656 cases (1.8 per 100 000 population). In the framework of CMI, 1169 surgeries were performed on parathyroid glands in 2023, representing no more than one third of all hospitalizations due to PHPT. Patients with PHPT were most often predictably consulted by endocrinologists, surgeons, oncologists; a large number of dermatologists’ consultations was unexpected. Conclusion. The revealed primary incidence of primary hyperparathyroidism in the Russian Federation is significantly lower than global indicators, that is probably due to the low frequency of blood calcium concentration tests in the population in the general network of state health facilities. It can be assumed that there is an insufficient delivery of surgical care (parathyroidectomy) as the only radical treatment method for patients with primary hyperparathyroidism.