Son dönem böbrek yetmezliği olan göçmen hastalarin demografik ve klinik özellikleri ile maliyetinin değerlendirilmesi

Amaç: Savaşlar ve afetler nedeniyle insanlar güvenli barınma ve sağlık hizmetlerine olan ihtiyaçlarından dolayı zorunlu olarak göç etmektedirler. Çalışmamızda son dönem böbrek hastalığı olan göçmenlerin demografik ve klinik özelliklerini ve maliyet analizini incelemeyi amaçladık. Gereç ve Yöntem: Çalışmamız tek merkezli ve retrospektif bir çalışmadır. Acil servise son dönem böbrek hastalığı semptomları ile başvuran ve çalışma kriterlerini karşılayan hastalar çalışmaya dahil edildi. Olguların demografik, klinik, laboratuvar ve tedavi maliyeti verileri önceden oluşturulan bir forma eklendi. Bulgular: Çalışmamız 696 hasta ile yapılmıştır. Vakaların %64,2'si kadındı ve ortanca yaş 67 idi. Olguların tamamına hemodiyaliz uygulandı, bunların %47'si acil olarak gerçekleştirildi. Bu vakaların %55,2'si hastaneye yatırıldı ve tüm vakaların %13,2'sinde ölüm görüldü. Mortalite olan olgularda yaş istatistiksel olarak daha yüksekti. Mortal seyreden hastalarda üre ve kreatinin düzeyleri anlamlı olarak daha yüksekken, pH, HCO3 ve GFR düzeyleri istatistiksel olarak daha düşüktü. Acil hemodiyaliz ve yoğun bakım gerektiren olgularda mortalite oranı istatistiksel olarak daha yüksekti. Hayatta kalan olgularda sağlık maliyetleri istatistiksel olarak daha yüksekti. Ayrıca, hastanede yatan olgularda yatış süresi ve sağlık maliyetleri ayaktan hastalara göre istatistiksel olarak daha yüksekti. Sonuç: Son dönem böbrek hastalığı olan göçmen vakaların belirlenerek rutin diyaliz programlarının oluşturulması, hastalar için hem mortalite ve morbiditeyi azaltacak hem de ülkelerdeki sağlık maliyetlerini azaltacak ve acil servisler üzerindeki yükü hafifletecektir

Anahtar Kelimeler:

Göçmenler, son dönem böbrek yetmezliği, maliyet, sağlık politikası

Evaluation of demographic, clinical characteristics and cost of immigrant patients with end-stage renal failure

Purpose: Due to wars and disasters, people migrate forcibly due to their need for safe housing and health care. In our study, we aimed to the demographic and clinical typical of immigrants with end-stage renal disease and to make a cost analysis. Materials and Methods: Our study is single-center and retrospective. Migrant patients who have end-stage renal disease who met the study criteria were included in the study. Demographic data, clinical data, laboratory data and treatment cost data of the cases were added to the previously created form. Results: Our study was conducted with 696 patients. 64.2% of the cases were female and the median age was 67 years. 65.5% of the cases were of Syrian nationality. Hemodialysis was applied to all of the cases, of which 47% were urgently. 55.2% of these cases were hospitalized and mortality was observed in 13.2% of all cases. Age was statistically higher in cases with mortality. Urea and creatinine in patients with mortality were significantly higher; pH, HCO3 and GFR were statistically lower. Mortality was statistically higher in cases requiring urgent hemodialysis and hospitalized in the ICU. The cost of health was statistically higher in surviving cases. Again, in patients who were hospitalized, both the time allocated for care and the cost of health were statistically higher than in outpatients. Conclusion: Establishing routine dialysis programs by identifying immigrant cases with end-stage renal disease will both reduce mortality and morbidity for patients, reduce health costs in countries, and reduce emergency department densities.

Keywords:

Immigrants, End Stage Kidney Failure, Cost, Health Policy,

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