Turkiye Klinikleri Archives of Lung

.: ORIGINAL RESEARCH
Economic Burden and Key Cost Drivers of Managing Hospitalized Chronic Obstructive Pulmonary Disease Patients Admitted with an Exacerbation in Türkiye: A Cost of Illness Study from Payer Perspective
Türkiye'de Alevlenme ile Yatırılan Kronik Obstrüktif Akciğer Hastalarının Yönetiminde Anahtar Maliyet Kalemleri ve Ekonomik Yük: Geri Ödeyici Perspektifinden Hastalık Maliyeti Çalışması
Mehmet POLATLIa, Ergün ÖKSÜZb, Simten MALHANc
aDepartment of Chest Diseases, Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
bDepartment of Family Medicine, Başkent University Faculty of Medicine, Ankara, Türkiye
cDepartment of Healthcare Management, Başkent University Faculty of Health Sciences, Ankara, Türkiye
Turkiye Klinikleri Arch Lung. 2022;21(2):39-50
doi: 10.5336/archlung.2022-88430
Article Language: EN
Full Text
ABSTRACT
 Objective: To estimate the economic burden and key cost drivers of managing exacerbated and hospitalized chronic obstructive pulmonary disease (COPD) patients in Türkiye. Material and Methods: This cost of illness study was based on an estimation of per patient annual direct medical costs for the management of exacerbated and hospitalized COPD patients in Türkiye from a payer perspective. The average per patient direct medical cost was calculated based on cost items related to outpatient visits, diagnostic laboratory and radiological tests, hospitalizations and interventions, training and rehabilitation, drug treatment and equipment, drug-related adverse events, and co-morbidities/complications. Results: Based on average annual per patient costs calculated for outpatient admission ($88.5), laboratory and radiological tests ($68.6), hospitalizations and interventions/training/rehabilitation ($1,181.3), drug treatment/equipment ($1,088.0), co-morbidities/complications ($1,291.7) and drug related adverse events ($11.8) cost items, per patient annual direct medical cost related to the management of exacerbated and hospitalized COPD patients was calculated to be $3,729.9 from the payer perspective. Co-morbidities/complications (34.6%), hospitalizations/interventions (31.7%) and drug treatment/equipment (29.2%) were the key cost driver. Results: In conclusion, our findings indicate that managing exacerbated and hospitalized COPD patients pose a considerable burden to health economics in Türkiye, with co-morbidities and hospitalizations estimated as the main cost drivers. Our findings emphasize the need for cost-effective prevention strategies and the likelihood of potential cost-savings by timely recognition and proper management of co-morbidities and by better disease control with reduced frequency of exacerbations and hospitalizations.

Keywords: Chronic obstructive pulmonary disease; exacerbations; practice patterns; cost analysis; Türkiye
ÖZET
 Amaç: Türkiye'de alevlenme geçiren ve hastanede yatırılarak tedavi edilen kronik obstrüktif akciğer hastalığı (KOAH) hastalarının ekonomik yükünü tespit etmek ve anahtar maliyet kalemlerini saptamak çalışmanın amacıdır. Gereç ve Yöntemler: Bu hastalık maliyeti çalışması geri ödeyici perspektifinden, yatırılarak tedavi edilen KOAH hastalığının yönetiminde hasta başı direkt maliyetleri hesaplamaya odaklanmıştır. Ortalama direkt tıbbi maliyetler poliklinik ziyaretleri, tanıda laboratuvar ve görüntüleme maliyetleri, yatış ve müdahaleler, eğitim ve rehabilitasyon, ilaç tedavisi ve komorbid ve komplikasyonlara ait maliyetleri kapsamaktadır. Bulgular: Ortalama hasta başı poliklinik ziyaretleri (88,5$), laboratuvar ve radyolojik test maliyeti (68,6 $), yatış ve müdahale/eğitim/rehabilitasyon (1.181,3$) ilaç tedavisi/tıbbi cihaz maliyeti (1.088,0$), komorbid/komplikasyon (1.291,7$) ve ilaç ilişkili yan etki maliyeti (11,8$) ve toplam hasta başı ortalama alevlenme ile yatış maliyeti 3.729,9 $ olarak geri ödeyici perspektifinden belirlenmiştir. Komorbiditeler ve komplikasyonlar (%34,6), yatış/ müdahale (%31,7) ve ilaç tedavi/cihaz maliyeti (%29,2) ile en yüksek maliyet kalemleri olarak tespit edilmiştir. Sonuç: Bulgularımız, alevlenme ile hastaneye yatan KOAH hastalarının Türkiye sağlık ekonomisine önemli bir yük getirdiğini göstermektedir. Komorbid hastalıklar ve yatış en önemli maliyet belirleyicileridir. Maliyet etkili ve zamanında maliyet tasarruflu potansiyel önleme stratejileri ile daha iyi hastalık kontrolü, komorbidlerin yönetimi ile alevlenmeler ve yatış sıklıkları azaltılabilir.

Anahtar Kelimeler: Kronik obstrüktif akciğer hastalığı; alevlenme; uygulama modeli; maliyet analizi; Türkiye
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