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

Türkiye’de Yatış Hizmeti Verilen Pediatrik Tip I Diyabetli Hastaların Maliyeti: Tek Merkezin Tecrübesi

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

Cost of Inpatient Pediatric Type 1 Diabetes Care in Turkey:Single Center Experience

Objective: To explore the financial cost of type 1 diabetic (T1D) children and adolescentsduring inpatient management for various reasons.Methods: Ten years of electronic hospital records (2009-2018) of the pediatric ward werescreened retrospectively and hospitalizations with a confirmed diagnose of T1D wereanalyzed. Costs are grouped as laboratory tests, clinical interventions, drugs, medicalsupplies, and total costs before being converted to US dollars according to the mid-year indexpublished by the Central Bank of Turkey. Descriptive statistics and comparisons againstpatient-specific characteristics are presented.Results: There were 400 eligible cases. Cost per case for the hospital and for the SocialSecurity Institution (SSI) were $268 and $309 respectively. The clinical intervention was thelargest (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 inthe ward were parameters influencing total cost significantly (p

PDF

___

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. [Internet]. National diabetes statistics report, 2017. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2017. [cited 2020 Jul 20] Available from: https://dev.diabetes.org/sites/default/files/2019-06/cdc-statistics-report-2017.pdf
3. DIAMOND Project Group. Incidence and trends of childhood Type 1 diabetes worldwide 1990 –1999. Diabet. 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. International Diabetes Federation [Internet]. IDF Diabetes Atlas Country Report. 8th ed. Brussels: 2017. Available from: https://www.idf.org/e-library/epidemiology-research/diabetes-atlas/134-idf-diabetes-atlas-8th-edition.html
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. Diabet. Med. 2017;34:405-10.
8. Yüksek Öğretim Kurulu Başkanlığı. [Internet]. Tez Merkezi. [cited 2020 July 19] Available from: 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 Ctries. 2014;34:77–81
11. World Health Organization Türkiye Diyabet Programı 2015-2020.; [Internet]. 2014. [cited 2020 July 19] Available from: https://extranet.who.int/ncdccs/Data/TUR_D1_T%C3%BCrkiye%20Diyabet%20Program%C4%B1%2020 15-2020.pdf
12. Mapa-Tassou C, Katte JC, Maadjhou CM, Mbanya JC. Economic Impact of Diabetes in Africa. Curr. Diab. 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. Bull. World Health Organ.. 2013;91:434-40.
14. Ying AK, Lairson DR, Giardino AP, Bondy ML, Zaheer I, Haymond MW, Heptulla RA. Predictors o f 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. Diabet. 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 Pediatr.. 2013;13:55.
17. Gray AM, Fenn P. The cost of insulin-dependent diabetes mellitus in England and Wales. Diabet. 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.
19. George, D., & Mallery, M. SPSS for Windows Step by Step: A Simple Guide and Reference, 17.0 update (10a ed.) Boston: Pearson. 2010
20. Gravetter, F., & Wallnau, L. Essentials of statistics for the behavioral sciences (8th ed.). Belmont, CA: Wadsworth. 2014.
21. Yavuz, S. Hataları Ardışık Bağımlı (Otokorelasyonlu) Olan Regresyon Modellerinin Tahmin Edilmesi. Ataturk University J of Eco.& Adm. Sci.. 2009. 23(3).
22. Kalaycı Ş. SPSS Uygulamalı Çok Değişkenli İstatistik Teknikleri, Asil Yayınları, Ankara. 2006.
23. Sağlık Uygulama Tebliği, Sosyal Güvenlik Kurumu, [Internet]. [cited 2020 July 19] Available from https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=17229&MevzuatTur=9&MevzuatTertip=5

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