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─░STANBUL ─░L─░NDE ├ť├ç HASTANEDE AYAKTAN ─░ZLENEN T─░P II D─░YABET─░K HASTALARDA GL─░SEM─░K KONTROL├ťN MAL─░YET ETK─░NL─░─×─░N─░N DE─×ERLEND─░R─░LMES─░ - THE COST EFFECTIVENESS of GLYCEMIC CONTROL in TYPE II DIABETIC PATIENTS UNDER FOLLOW-UP in THREE HOSPITALS in ISTANBUL | ├ľns├╝z | Eski┼čehir T├╝rk D├╝nyas─▒ Uygulama ve Ara┼čt─▒rma Merkezi Halk Sa─čl─▒─č─▒ Dergisi (ISSN:2564-6311)

─░STANBUL ─░L─░NDE ├ť├ç HASTANEDE AYAKTAN ─░ZLENEN T─░P II D─░YABET─░K HASTALARDA GL─░SEM─░K KONTROL├ťN MAL─░YET ETK─░NL─░─×─░N─░N DE─×ERLEND─░R─░LMES─░ - THE COST EFFECTIVENESS of GLYCEMIC CONTROL in TYPE II DIABETIC PATIENTS UNDER FOLLOW-UP in THREE HOSPITALS in ISTANBUL

Muhammed Fatih ├ľns├╝z, Ahmet Topuzo─člu

├ľz


Diyabet gittik├že artan maliyete sahip bir kronik hastal─▒kt─▒r. Diyabetin kontrol ve tedavisinde en┬á├Ânemli hedef ise glisemik kontrold├╝r. Ara┼čt─▒rman─▒n amac─▒; ─░stanbulÔÇÖda hizmet veren ├╝├ž ayr─▒┬áhastanede ayaktan izlenen tip II diyabetik hastalarda glisemik kontrol i├žin kullan─▒lan tedavilerin┬ámaliyet etkilili─činin de─čerlendirilmesidir. Ara┼čt─▒rma, ─░stanbulÔÇÖda devlet, ├╝niversite ve ├Âzel┬áolmak ├╝zere ├╝├ž ayr─▒ hastaneye kontrol i├žin ba┼čvuran en az alt─▒ ayl─▒k tan─▒l─▒ 392 tip II diyabet┬áhastas─▒ ile y├╝r├╝t├╝lm├╝┼č bir maliyet-etkililik ara┼čt─▒rmas─▒ idi. Veriler, ara┼čt─▒rmac─▒lar taraf─▒ndan┬áhaz─▒rlanan iki b├Âl├╝mden olu┼čan bir anket formu uygulanarak topland─▒. Maliyet etkililik┬áanalizinde her hastane i├žin al─▒nan tedavi t├╝r├╝ne g├Âre toplam maliyet ve etkililik hesapland─▒.┬á─░statistiksel analizler SPSS paket program─▒nda tan─▒mlay─▒c─▒ istatistikler ve X2 testi kullan─▒larak┬áde─čerlendirildi. De─či┼čkenlerin birlikte glisemik kontrol├╝n toplam maliyetinin ne kadar─▒n─▒┬áa├ž─▒klad─▒─č─▒n─▒ belirlemek amac─▒yla ├žoklu regresyon analizi kullan─▒ld─▒. Ara┼čt─▒rmaya kat─▒lan┬áhastalar─▒n %59.2ÔÇÖsinin HgbA1c d├╝zeyleri normaldi ve hastaneler aras─▒nda hastalar─▒n HgbA1c┬ád├╝zeyleri a├ž─▒s─▒ndan istatistiksel olarak anlaml─▒ fark bulundu (p<0.001). ├çoklu regresyon┬áanalizinde; ba┼čvurulan hastane, hastal─▒─č─▒n s├╝resi, al─▒nan tedavi t├╝r├╝, hastan─▒n BK─░ ve HgbA1c┬áde─čeri glisemik kontrol├╝n toplam maliyetini artt─▒ran fakt├Ârler olarak, diyet listesini uygulama┬ádurumu ise maliyeti azaltan fakt├Âr tespit edildi. Ayr─▒ca analiz sonucunda ba┼čvurulan hastane┬ág├Âreli olarak en ├Ânemli de─či┼čken olarak bulundu. Oral antidiyabetik (OD) tedavi i├žin ise,┬á├╝niversite hastanesi maliyet etkililik a├ž─▒s─▒ndan maliyeti d├╝┼č├╝k ve etkilili─či y├╝ksek olarak┬ábulundu ve maliyet-etkililik analizinde kabul sonucu saptand─▒. Tip II diyabetik hastalardaki┬átedavilerin etkinli─či ve maliyeti her ├╝├ž hastanedeki poliklinik uygulamalar─▒ a├ž─▒s─▒ndan┬ákar┼č─▒la┼čt─▒r─▒lm─▒┼č ve farkl─▒ bulunmu┼čtur.

Anahtar Kelimeler: Diabetes mellitus, Hastane, Maliyet, Maliyet etkililik

 

THE COST EFFECTIVENESS OF GLYCEMIC CONTROL IN TYPE II DIABETIC
PATIENTS UNDER FOLLOW-UP IN THREE HOSP─░TALS IN ISTANBUL

Abstract:
Diabetes mellitus is a chronic disease with increasing health costs. The major target in the control and treatment of diabetes is the glycemic control. The aim of this study was to evaluate the cost-effectiveness of glycemic control in type II diabetic patients under follow-up in three hospitals in Istanbul. This is a cost-effectiveness study conducted on 392 patients with a diagnosis of type II diabetes for at least 6 months who were under follow-up in a total of three
state, university and private hospitals in Istanbul. Data were collected by using a two-section questionnaire form prepared by the researchers. Cost-effectiveness is analyzed by calculating the total cost and effectiveness by the treatment method in each hospital. Statistical analysis was performed on SPSS package program and by using descriptive statistics and X2 test. Multiple regression analysis was used to determine whether the variables can explain the total
cost of glycemic control. The HbA1c level was normal in 59.2% of the participants and differed significantly between the patients from different hospitals (p<0.001). Multiple regression analysis revealed the factors increasing the cost as the hospital admitted, disease duration, treatment type, BMI and HBA1c level, while the factor decreasing the cost was compliance to the diet list. Importantly, the relatively most significant variable was the hospital admitted. For the treatment with oral antidiabetics (OD), university hospitals had the least cost and highest effectiveness with an acceptable cost-effectiveness. Effectiveness and cost of the therapy in Type II diabetic patients were compared and found to be different between the outpatient clinics in three hospitals. 

Key words: Diabetes mellitus, Hospital, Cost, Cost-effectiveness


Tam Metin:

ARTICLE 1

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