Real World Data Estimation: Management and Cost-analysis of Stroke in Tertiary Hospitals in Turkey and the Impact of Co-morbid Malnutrition
Küçük Resim Yok
Tarih
2016
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Serebrovasküler olay nedeniyle ilk kez hastaneye başvuran hastalarda hastalık yönetimi ve maliyet analizini değerlendirerek, ko-morbid malnütrisyonun etkisini belirlemek. Yöntem: Bu çalışmada malnütrisyonu olan ve olmayan serebrovasküler olay tanılı hastalarda hastalık yönetimi ve maliyet analizine yönelik olarak uzman görüşleri, uzmanların günlük klinik pratikteki uygulamalarını yansıtacak şekilde doldurdukları standardize anket formları aracılığı ile belirlendi. Maliyet kalemlerini medikal tedavi, sağlık kaynakları kullanımı, testler, konsültasyonlar ve komplikasyonlar oluşturdu. Başvuru başına ve toplam yıllık doğrudan medikal maliyet ko-morbid malnütrisyon varlığına göre hesaplandı. Bulgular: Malnütrisyon başvuru esnasında hastaların %7.8(3.6) [ortalama (standart hata; SEM)]' sinde mevcut olup, ilave olarak hastaların %7.1(4.8) ve %0.9(0.6)' sı nörolojik yoğun bakım ve inme ünitesindeki yatışları esnasında malnütrisyon geliştirdi. Hospitalizasyon süresi malnütrisyonu olan hastalarda 2 kat daha uzun idi (P<0.01, tüm hastane birimleri için). 1yıllık takip dönemi içinde malnütrisyonu olan ve olmayan hastaların sırasıyla ortalama (SEM) %93.8(15.4) ve% 43.3(3.7)'sine en az bir komplikasyon gelişimi beklendiği tespit edildi. Hasta başına ortalama (SEM) yıllık serebrovasküler olay maliyeti malnütrisyonu olan hastalarda US$ 5201(740) ve malnütrisyonu olmayanlarda ise US$ 3619(614) olup, başvuru başına maliyet açısından karşılık gelen değerler sırasıyla US$ 3061(513) ve US$ 1958(372) olarak belirlendi. Sonuç: Sonuç olarak, bulgularımız serebrovasküler olay ve komplikasyonlarına dair hastalık yönetiminin Türk sağlık ekonomisi üzerinde göreli olarak yüksek bir maliyet yükü oluşturduğu yönündedir. Üstelik, ko-morbid malnütrisyon, nadir karşılaşılan bir durum olmamasının yanı sıra, toplam maliyet yükünde artış, daha uzun süreli hospitalizasyon ve 1yıllık takip süresince daha yüksek oranda komplikasyon beklentisi ile ilişkili bulunmuştur
To evaluate the management and cost analysis of first-ever stroke patients in Turkey and determine the impact of comorbid malnutrition. Methods: This study was based on expert's view on the management and cost analysis of stroke patients with or without malnutrition via standardized questionnaire forms filled by experts according to their daily clinical practice. Cost items were related to medical treatment, healthcare resources utilization, tests, consultations and complications. Per admission and total annual direct medical costs were calculated with respect to co-morbid malnutrition. Results: Malnutrition was evident in 7.8(3.6)% [mean(standard error of mean; SEM)] of patients at admission; an additional 7.1(4.8)% and 0.9(0.6)% patients developed malnutrition during Neuro-ICU and stroke unit hospitalization, respectively. Length of hospital stay (LOS) was almost 2-fold in patients with malnutrition (P<0.01 for all hospital units). During the 1year follow-up period a mean(SEM) of 93.8(15.4)% with and 43.3(3.7)% without malnutrition were expected to experience at least 1 complication. the mean (SEM) per patient annual cost of stroke was US$ 5201(740) in patients with malnutrition and US$ 3619(614) in patients without malnutrition, while the corresponding figures for per admission were US$ 3061(513) and US$ 1958(372), respectively. Conclusions: in conclusion, our findings revealed that management of stroke and its complications have a relatively high burden on the Turkish health reimbursement system. Furthermore, co-morbid malnutrition, being not uncommonly encountered, increased the overall costs and was associated with longer LOS and higher rate of expected complications during 1-year follow up
To evaluate the management and cost analysis of first-ever stroke patients in Turkey and determine the impact of comorbid malnutrition. Methods: This study was based on expert's view on the management and cost analysis of stroke patients with or without malnutrition via standardized questionnaire forms filled by experts according to their daily clinical practice. Cost items were related to medical treatment, healthcare resources utilization, tests, consultations and complications. Per admission and total annual direct medical costs were calculated with respect to co-morbid malnutrition. Results: Malnutrition was evident in 7.8(3.6)% [mean(standard error of mean; SEM)] of patients at admission; an additional 7.1(4.8)% and 0.9(0.6)% patients developed malnutrition during Neuro-ICU and stroke unit hospitalization, respectively. Length of hospital stay (LOS) was almost 2-fold in patients with malnutrition (P<0.01 for all hospital units). During the 1year follow-up period a mean(SEM) of 93.8(15.4)% with and 43.3(3.7)% without malnutrition were expected to experience at least 1 complication. the mean (SEM) per patient annual cost of stroke was US$ 5201(740) in patients with malnutrition and US$ 3619(614) in patients without malnutrition, while the corresponding figures for per admission were US$ 3061(513) and US$ 1958(372), respectively. Conclusions: in conclusion, our findings revealed that management of stroke and its complications have a relatively high burden on the Turkish health reimbursement system. Furthermore, co-morbid malnutrition, being not uncommonly encountered, increased the overall costs and was associated with longer LOS and higher rate of expected complications during 1-year follow up
Açıklama
Anahtar Kelimeler
Nörolojik Bilimler
Kaynak
Journal of Neurological Sciences (Turkish)
WoS Q Değeri
Scopus Q Değeri
Cilt
33
Sayı
3
