Türkiye’deki Bir Üniversite Hastanesinde Yatarak Tedavi Edilen COVID-19 Hastalarının Tedavi Maliyet Analizi

Year 2021, Volume: 13 Issue: S1, 421 - 428, 30.08.2021

Enver Bozdemir , Öner Balbay , Melek Terzi , Zekeriya Kaplan

https://doi.org/10.18521/ktd.905115

Cited By: 1

Abstract

Amaç: Coronavirus Hastalığı-2019 (COVID-19) nedeniyle Düzce Üniversitesi Sağlık Uygulama ve Araştırma Merkezinde (Hastanesinde- DUHARH) yatarak tedavi gören hastaların Sosyal Güvenlik Kurumu (SGK) perspektifi açısından maliyet analizini yaparak hem hastane yönetimine hem de hastalığın yönetim sürecinde rol oynayan sağlık politikası yapıcılarına yol göstermektir.
Materyal ve Metod: Araştırma, DUHARH’da COVID-19 hastalığı nedeniyle yoğun bakım ve diğer kliniklerde Mart/2020-Aralık/2020 dönemi içerisinde yatarak tedavi edilen 582 hastayı kapsamaktadır. Araştırmada örneklem seçilmemiş evrenin tamamı çalışmaya dahil edilmiştir. Retrospektif olarak elde edilen veriler, aşağıdan yukarı, doküman analizi ve çok değişkenli regresyon analiz yönetimiyle analiz edilmiştir.
Results: Araştırma yapılan 582 hastanın %60’ı erkek (350 kişi), %40 kadın (232 kişi), ortalama yatış süresi 5,7 gün, Pandemi Yoğun Bakım Ünitesinde %23 (134 kişi) diğer pandemi servislerinde %77 (448 kişi) olduğu tespit edilmiştir. Hastane tarafından SSI’ya fatura edilen toplam tutar 7.378.695,00 TL ($1,052,595) olup bunun %79’nun müdahale maliyeti olduğu ve hasta başı günlük ortalama yatış maliyetin ± 2.099,80 TL ($ 299,54) olduğu saptanmıştır. Ayrıca cinsiyet ayrımının (erkeklerin), yaşlı hastaların, yatış yerinin (yoğun bakım) ve yatış süresi P<0.05 olduğundan ilaç, malzeme, müdahale ve tetkik maliyetlerini artırdığı tespit edilmiştir.
Sonuç: Yapılan çalışmada erkeklerin, yaşın ve yatış süresinin artması ve yoğun bakımda tedavi edilmenin maliyetleri artırdığı ve bunlar içerisinde en yüksek müdahale maliyetlerinin olduğu tespit edilmiştir. Hastalık maliyetinin azaltılması için daha düşük bedelli maliyet unsurlarına başvurulması, kısıtlamalarla hastalığın bulaş hızının ortadan kaldırılması ve nihayetinde tüm halkın bir an önce aşılanması gerekir.

Keywords

COVID-19, hastalık maliyeti, tedavi maliyeti, maliyet yönetimi

Treatment Cost Analysis of COVID-19 Inpatients Treated at a University Hospital in Turkey

Abstract

Objective: To guide both the hospital management and the health policymakers who play a role in the management process of their disease by analysing the costs of the patients receiving inpatient treatment in Düzce University Health Application and Research Center (Hospital - DUHARH) due to coronavirus disease 2019 (COVID-19) from the perspective of the Social Security Institution (SSI).
Material and Method: The study covers 582 patients who received inpatient treatment in intensive care and other clinics in March/2020-December/2020 due to COVID-19 disease in DUHARH. In the study, all sample unselected populations were included. Retrospectively obtained data were analysed using bottom-up, document analysis, and multivariate regression analysis.
Results: It was determined that 60% of the 582 patients studied were male (350 people), 40% female (232 people) and that the average hospitalization period was 5.7 days, 23% (134 people) in the Pandemic Intensive Care Unit and 77% (448 people) in other pandemic services. The total amount invoiced to SSI by the hospital was 7.378.695,00 TRY ($ 1,052,595). It was determined that 79% of this was the intervention cost and the average daily hospitalization cost per patient was ± 2,099.80 TRY ($ 299.54). Besides, since gender discrimination is male, elderly patients are hospitalized in intensive care. The hospitalization period is P<0.05. It was observed that medicine, material, intervention, and examination costs have increased.
Conclusion: In the study conducted, it was observed that the increase in men, age and hospitalization period, and treatment in intensive care increased the costs, and among these, the intervention costs were the highest. To reduce the cost of illness, it is necessary to use lower-cost factors to eliminate the disease rate with restrictions and ultimately to vaccinate the whole population as soon as possible.

Keywords

COVID-19, cost of illness, cost of treatment, cost management

References

• 1. World Health Organization, Timeline of WHO’s response to COVID-19. [Internet]. Switzerland: World Health Organization; 2019 Jan [cited 2021 Jan 13]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interactive-timeline#event-0
• 2. World Health Organization. Coronavirus Disease (COVID-19) [Internet]. Switzerland: World Health Organization; 2020 Jan [cited 2021 Jan 13]. Available from: https://covid19.who.int/region/euro/country/tr
• 3. Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD. How will country-based mitigation measures influence the course of the COVID-19 epidemic?. Lancet. 2020;395(10228):931-34.
• 4. Oshaghi EA, Mirzaei F, Farahani F, Khodadadi I, Tayebinia H. Diagnosis and treatment of coronavirus disease 2019 (COVID-19): Laboratory, PCR, and chest CT imaging findings. Int. J. Surg. 2020;79:143-53.
• 5. Zu ZY, Jiang MD, Xu PP, Chen W. Coronavirus disease 2019 (COVID-19): a perspective from China. Radiology. 2020;296(2):E15–E25.
• 6. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 2020;395(10223):497-06.
• 7. Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N. Engl. J. Med. 2020;382(18):1708-20.
• 8. Cummings MJ, Baldwin MR, Abrams D, Jacobson SD, Meyer BJ, Balough EM, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet. 2020;395(10239):1763-70.
• 9. Sugiyama M, Kinoshita N, Ide S, Nomoto H, Nakamoto T, Saito S, et al. Serum CCL17 level becomes a predictive marker to distinguish between mild/moderate and severe/critical disease in patients with COVID-19. Gene. 2021;766:1-9.
• 10. Khan A, AlRuthia Y, Balkhi B, Alghadeer SM, Temsah MH, Althunayyan SM, et al. Survival and estimation of direct medical costs of hospitalized covid-19 patients in the Kingdom of Saudi Arabia (Short Title: COVID-19 survival and cost in Saudi Arabia). Int. J. Environ. Res. Public Health. 2020;17(20):1-12.
• 11. Jin H, Wang H, Li X, Zheng W, Ye S, Zhang S, et al. Economic burden of COVID-19, China, January-March, 2020: a cost-of-illness study. Bull World Health Organ. 2021;99(2):112–24.
• 12. Li XZ, Jin F, Zhang JG, Deng YF, Shu W, Qin JM, et al. Treatment of coronavirus disease 2019 in Shandong, China: A cost and affordability analysis. Infect. Dis. Poverty. 2020;9(1):78.
• 13. Gedik H. The Cost analysis of inpatients with COVID-19. Acta Medica Mediterr. 2020;36(1):3289-92.
• 14. Ahmad T, Baig HM, Hui J. Coronavirus disease 2019 (COVID-19) pandemic and economic impact. Pakistan Journal of Medical Sciences. Professional Medical Publications. 2020;36(COVID19-S4):S73-S78.
• 15. Yamin M. Counting the cost of COVID-19. Int. J. Inf. Technol. Jun. 2020;12(2):311-17.
• 16. You S, Wang H, Zhang M, Song H, Xu X, Lai Y, et al. Assessment of monthly economic losses in Wuhan under the lockdown against COVID-19. Humanit. Soc. Sci. Commun. 2020;7(1):1–12.
• 17. Luo S, Tsang KP. China and world output impact of the hubei lockdown during the coronavirus outbreak. Contemp. Econ. Policy. Oct. 2020;38(4):583-92.
• 18. Wachter TV. Lost generations: long-term effects of the COVID-19 crisis on job losers and labour market entrants, and options for policy. Fisc. Stud. Sep. 2020;41(3):549-90.
• 19. Türkiye Cumhuriyeti Sağlık Bakanlığı. COVID-19 erişkin tedavi algoritmasi [Internet]. Turkey: Türkiye Cumhuriyeti Sağlık Bakanlığı; 2020 Jan [cited: 2021 Jan 4]. Available from: https://covid19.saglik.gov.tr/Eklenti/37690/0/covid19-plkacilhastayonetimipdf.pdf?_tag1=E514708F4392A533E2E8FCF139838B92CC444CD4.
• 20. Olsson TM. Comparing top-down and bottom-up costing approaches for economic evaluation within social welfare .Eur. J. Heal. Econ. Oct. 2011;12(5):445-53.
• 21. Cunnama L, Sinanovic E, Ramma L, Foster N, Berrie L, Stevens W, et al. Using top-down and bottom-up costing approaches in lmics: the case for using both to assess the incremental costs of new technologies at scale. Heal. Econ. (United Kingdom). 2016;(Suppl Suppl 1):53–66.
• 22. Gujarati DN. Basic econometrics. Noida. Tata McGraw-Hill Education; 2012.
• 23. Bartsch SM, Ferguson MC, McKinnell JA, O'Shea KJ, Wedlock PT, Siegmund S, et al. The potential health care costs and resource use associated with COVID-19 in the United States. Health Aff. 2020;39(6):927-35.
• 24. Miethke-Morais A, Cassenote A, Piva H, Tokunaga E,Cobello V, Gonçalves FAR, et al. Unraveling COVID-19-related hospital costs: The impact of clinical and demographic conditions. medRxiv. Health Econ. 2020;1-24.
• 25 Lee JK, Kwak BO, Choi JH, Choi EH, Kim JH, Kim DH, et al. Financial burden of hospitalization of children with coronavirus disease 2019 under the national health insurance service in Korea. J. Korean Med. Sci. 2020;35(24).e224.
• 26. Rs 3.5 lakh spent on each Covid-19 patient in Victoria Hospital: Karnataka minister. India: Bengaluru News-Times of India. [Internet]. 2020 May [cited: 2021 Jan 20]. Available from: https://timesofindia.indiatimes.com/city/bengaluru/rs-3-5-lakh-spent-on-each-covid-19-patient-in-victoria-hospital-karnataka-minister/articleshow/75639482.cms.
• 27. Thom H, Walker J, Vickerman P, Hollingworth W. Comparison of Healthcare costs and benefits of the UK’s COVID-19 response with four European countries: decision modelling study. medRxiv. Health Econ. 2020;1-42.
• 28. Bozdemir E, and Taşlı M. Hastalık Maliyet Analizinin Bibliyometrik ve Doküman Açısından İncelemesi. Konuralp Medical Journal. 2018;10(3):408-419.
• 29. Akcan FA, Onec K, Annakkaya A, Pehlivan M, Karaduman ZO, Balbay Ö, et al. Pandemi Sürecinde Düzce Üniversitesi Hastanesi: Başhekimlik Yönünden. Konuralp Medical Journal. 2020;12(S1): 354-357.