Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia
Pnömoni Tanısı ile Hospitalize Edilen Demanslı Hastalarda Direkt Maliyetin Değerlendirilmesi
Bilge YILMAZ KARAa, Neslihan ÖZÇELİKa, Songül ÖZYURTa
aDepartment of Pulmonary Medicine, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, TURKEY
Turkiye Klinikleri J Health Sci. 2021;6(3):531-7
doi: 10.5336/healthsci.2020-77094
Article Language: EN
Full Text
ABSTRACT
 Objective: Pneumonia is an indisputable cause of morbidity and mortality in elderly patients especially if they have dementia. We aimed to compare the cost of pneumonia for hospitalized patients with and without dementia and to investigate the factors affecting the direct cost of hospitalization. Material and Methods: The study group consisted of 58 dementia patients hospitalized for pneumonia compared with a matched cohort of 54 patients without dementia. The data were collected from the hospital record system between May 2017 and June 2019. Demographic features, comorbidities, characteristics of pneumonia and factors contributing to the total cost of hospitalization were analysed retrospectively. Results: The total mean cost of all patients for hospitalization of pneumonia was 653.1±1,059.9 American Dollars. The mean cost in the dementia group is 976.14±1,433.83 and 339.01±180.81 American Dollars for the control group per episode (p=0.001). The mean length of stay is 10.24±6.97 days and 7.24±2.89 days in the dementia and control groups, respectively (p<0.05). The number of consultations, pharmacy costs, examination costs and the total costs of patients with dementia were significantly higher than those without dementia and independent of the parameters associated with the characteristics of pneumonia. Conclusion: This study shows that pneumonia in elderly patients with dementia produces a burdensome financial cost which is lower in a matched population of patients without dementia. Advances in elderly care, precautions for pneumonia and assessment of aspiration risk in dementia patients might be rational solutions for decreasing the cost of pneumonia.

Keywords: Dementia; elderly; hospital costs; pneumonia
ÖZET
 Amaç: Pnömoni, özellikle yaşlı hastalarda tartışılmaz bir morbidite ve mortalite nedenidir. Çalışmamızın amacı, pnömoni tanısı ile hospitalize edilen demansı olan ve olmayan hastaların, hastanede yatış maliyetini karşılaştırmak ve direkt maliyete etki eden faktörleri değerlendirmektir. Gereç ve Yöntemler: Çalışmaya, pnömoni tanısı ile interne edilip, tedavi edilen demans tanılı 58 hasta ve benzer özellikteki demans tanısı olmayan 54 hasta dâhil edildi. Hastane kayıt sistemine Mayıs 2017 ile Haziran 2019 tarihleri arasında kaydedilen hasta verileri incelendi. Hastaların demografik özellikleri, komorbiditeleri, pnömoniye ait özellikler ve direkt hastane maliyetine etki eden faktörler retrospektif olarak değerlendirildi. Bulgular: Pnömoni tanısı ile hospitalize edilen hastaların toplam direkt maliyeti 653,1±1.059,9 Amerikan Doları olarak değerlendirildi. Demansı olan hastalarda, yatış başına ortalama maliyet 976,14±1.433,83 Amerikan Doları iken demansı olmayan hastalarda maliyetin 339,01±180,81 Amerikan Doları olduğu gözlendi (p=0,001). Ortalama yatış süresi demanslı hastalarda ve kontrol grubunda sırasıyla 10,24±6,97 gün ve 7,24±2,89 gün idi (p<0,05). Konsültasyon sayısı, ilaç maliyetleri, muayene ücretleri ve toplam maliyetin, demanslı hastalarda pnömoninin klinik özelliklerinden bağımsız olarak kontrol grubuna göre anlamlı ölçüde daha yüksek olduğu gözlendi. Sonuç: Bu çalışmanın sonuçları, pnömoni tanısı ile interne edilen demanslı hastaların, benzer özellikteki demansı olmayan hastalara göre anlamlı oranda fazla direkt finansal maliyeti olduğunu göstermiştir. Yaşlı bakımındaki gelişmeler, pnömoni gelişiminin önlenmesi için alınacak tedbirler ve aspirasyon riskinin değerlendirilmesi ile demanslı hastalarda aşırı maliyet yükünden kaçınılması mümkün olabilmektedir.

Anahtar Kelimeler: Demans; yaşlı; hastane maliyetleri; pnömoni
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