Eren CAM, Mehmet Nurullah KURUTKAN, İlknur ARSLANOĞLU, Okan BÜTÜNER

Amaç: Tip 1 diyabetli (T1D) çocuk ve adolesanların değişik nedenlerle yatarak tedavisinin maliyetini ortaya koymak Yöntem: Hastanenin elektronik hasta kayıtları 10 yıl geriye kadar (2009-2018) tarandı ve T1D olduğu doğrulanan olgular irdelendi. Maliyetler laboratuvar testleri, klinik girişimler, ilaçlar, tıbbi malzeme ve total olarak gruplandı ve Merkez Bankası yıl ortası verilerine göre Amerikan dolarına çevrildi. Tanımlayıcı istatistikler ve hasta verileriyle karşılaştırmalar sunuldu. Bulgular: Dörtyüz olgunun hastaneye ve Sosyal Güvenlik Kurumu’na ortalama maliyeti sırasıyla 268 ve 309 dolardı. En yüksek maliyet klinik girişim (% 49.84 ve 55.33), en düşük maliyet (% 0.43 ve 0.55) medikal malzemeyle ilgiliydi. Kan pH sı, HbA1c, tek ebeveyni olmak ve hastanede yatış süresi maliyeti anlamlı olarak etkilemekteydi (p

Anahtar Kelimeler:

Maliyet, Tip 1 diyabet, çocuk, yatarak tedavi, Türkiye

Cost Of Inpatient Pediatric Type 1 Dıabetes Care In Turkey: Sıngle Center Experıence

Objective: To explore the financial cost of type 1 diabetic (T1D) children and adolescents during inpatient management for various reasons. Method: Ten years of electronic hospital records (2009-2018) of the pediatric ward were screened retrospectively and hospitalizations with a confirmed diagnose of T1D were analyzed. Costs are grouped as laboratory tests, clinical interventions, drugs, medical supplies, and total costs before being converted to US dollars according to the mid-year index published by the Central Bank of Turkey. Descriptive statistics and comparisons against patient-specific characteristics are presented. Results: There were 400 eligible cases. Cost per case for the hospital and for the Social Security Institution (SSI) were $268 and $309 respectively. The clinical intervention was the largest (49.84 vs 55.33 %) and that of medical supplies was the smallest (0.43 vs 0.55 %) component of the cost. Blood pH, HbA1c, having a single parent, and the number of days in the ward were parameters influencing total cost significantly (p

Keywords:

cost, type 1 diabetes, pediatric, inpatient, Turkey,

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1. American Diabetes Association. Economic costs of diabetes in the US in 2017. Diabetes care. 2018;41(5):917-928.
2. Centers for Disease Control and Prevention. National diabetes statistics report, 2017. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2017.
3. DIAMOND Project Group. Incidence and trends of childhood Type 1 diabetes worldwide 1990–1999. Diabetic Med. 2006;23:857-66.
4. Stipancić G, La Grasta Sabolić L, Pozgaj Sepec M, Radica A, Skrabić V, Severinski S, Kujundzić Tiljak M. Regional differences in incidence and clinical presentation of type 1 diabetes in children aged under 15 years in Croatia. Croat Med J. 2012;53:141-8.
5. Patterson CC, Dahlquist GG, Gyürüs E, Green A, Soltész G and EURODIAB Study Group. Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–20: a multicentre prospective registration study. The Lancet. 2009;373:2027-33.
6. IDF Diabetes Atlas Country Report. 8th ed. Brussels:International Diabetes Federation; 2017.
7. Yeşilkaya E, Cinaz P, Andıran N, Bideci A, Hatun Ş, Sarı E et al. First report on the nationwide incidence and prevalence of Type 1 diabetes among children in Turkey. Diabetic Med. 2017;34:405-10.
8. YüksekÖğretim Kurulu Başkanlığı. Tez Merkezi. [cited 2020 July 19] https://tez.yok.gov.tr/UlusalTezMerkezi
9. https://dergipark.org.tr/tr/search?q=title%3A+%22cost+AND+diabetes+AND+Turkey%22§ion=articles
10. Keskek SO, Kirim S, Yanmaz N, Keskek NS, Ortoglu G, Canataroglu A. Direct medical cost of type 1 and type 2 diabetes in Turkey. Int J Diabetes Dev C. 2014;34:77–81
11. Türkiye Diyabet Programı 2015-2020. Türkiye Halk Sağlığı Kurumu; 2014.
12. Mapa-Tassou C, Katte JC, Maadjhou CM, Mbanya JC. Economic Impact of Diabetes in Africa. Curr Diabetes Rep. 2019;19:5.
13. Cobas RA, Ferraz MB, Matheus ASDM, Tannus LRM, Negrato CA, Araujo LAD et al. The cost of type 1 diabetes: a nationwide multicentre study in Brazil. Bulletin of World Health Organization. 2013;91:434-40.
14. Ying AK, Lairson DR, Giardino AP, Bondy ML, Zaheer I, Haymond MW, Heptulla RA. Predictors of direct costs of diabetes care in pediatric patients with type 1 diabetes. Pediatr Diabetes. 2011;12:177-82.
15. Currie CJ, Poole CD, Woehl A, Morgan CL, Cawley S, Rousculp MD et al. The financial costs of healthcare treatment for people with Type 1 or Type 2 diabetes in the UK with particular reference to differing severity of peripheral neuropathy. Diabetic Med. 2007;24:187-94.
16. Jasinski CF, Rodriguez-Monguio R, Tonyushkina K, Allen H. Healthcare cost of type 1 diabetes mellitus in new-onset children in a hospital compared to an outpatient setting. BMC Pediatrics. 2013;13:55.
17. Gray AM, Fenn P. The cost of insulin-dependent diabetes mellitus in England and Wales. Diabetic Med. 1995;12:1068-76.
18. Weinger K, Beverly EA, Lee Y, Sitnokov L, Ganda OP, Caballero AE. The effect of a structured behavioral intervention on poorly controlled diabetes: a randomized controlled trial. Arch Intern Med. 2011;171:1990-9.

ISSN: 1309-3878
Yayın Aralığı: 3
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez