Development of individual sanatorium programs spa treatment of patients with a phthisiological profile using a medical decision support system

The informatization of medical decisions, which affects the clinical outcomes of therapeutic resort care (TRC), can modify both the qualitative and quantitative aspects of resource utilization within organizational operations. Additionally, TRC methods and techniques may achieve greater medical and economic efficiency by using digital tools, particularly clinical decision support systems (CDSS), to develop personalized care programs. Objective. To develop an organizational model for creating an individualized TRC program within a therapeutic resort organization’s digital environment. Materials and methods. This study analyzed a cohort of 500 tuberculosis patients treated at the «Golubaya Bukhta» Tuberculosis Resort (Gelendzhik). The study cohort included adult patients (both males and females) aged 35 to 75 years who were completing chemotherapy, undergoing medical rehabilitation after surgical treatment, experiencing post-tuberculosis changes, following tuberculosis relapse, co-infected with Mycobacterium tuberculosis/human immunodeficiency virus (MBT/HIV), or belonging to socially at-risk groups. Simple randomization was used to form two statistically equivalent groups (1:1) of 250 subjects each. In the main group, the treatment plan was developed using the CDSS, with the information system generating preliminary recommendations that were subsequently adjusted by the physician, and the final decision made by a multidisciplinary team. In the comparison group, the TRC programs were developed using a traditional approach, based on the physician’s clinical experience and established treatment protocols (clinical guidelines, standards of medical care). The new organizational model was tested and its effectiveness assessed across multiple parameters. Results. The methods described and applied in the study facilitated the creation of an organizational model for developing individualized TRC programs. Pilot testing of the new organizational model improved the diagnostic component of TRC and optimized costs. The most notable changes involved organizing consultative care, reducing the proportion of consultations in total treatment costs. Laboratory diagnostics decreased by 12%, accounting for 6.8% of total costs, down from 7.2% previously. The treatment process shifted, with increased use of non-pharmacological methods, particularly physical therapy. The standard 40-day TRC course for patients diagnosed with A16 was maintained, while implementing the CDSS significantly reduced overall treatment costs. Conclusions. The findings indicate that using CDSS to provide medical care to patients in tuberculosis resort facilities ensures an optimal balance between quality of care and efficient resource use, a critical factor in improving the management of medical organizations and their structural units.