Öz
Giriş: Aralık 2019’da, Çin’in Wuhan kentinde Akut solunum sendromu Koronavirüs-2 ile ilişkili pnömoni ortaya çıkmıştır. Pandeminin ulusal ve küresel ekonomiler üzerindeki etkileri çok büyük olmuştur. Hastanelerin tedavi maliyetleri ve komorbiditelerin tedavi maliyetleri üzerindeki etkileri hakkında sınırlı kanıt bulunmaktadır ve bu bilgiler sağlık politikası yapıcıları için önemli girdilerdir. Bu çalışmanın temel amacı, Türkiye’de hastanede yatan Koronavirüs hastalığı-2019 (COVID-19) hastalarının doğrudan sağlık hizmeti maliyetlerini retrospektif olarak belirlemek ve komorbiditelerin bu maliyetler üzerindeki etkisinin belirlenmesidir.
Gereç ve Yöntem: Bu çalışma, COVID-19 salgınının ilk yılında İzmir’de hasta takibi en fazla olan iki eğitim ve araştırma hastanesinde yapılmıştır. Maliyet rakamlarının hesaplanması için General Linear Models kullanılmıştır. Sırasıyla, 2.067 COVID-19 hastasının hastaneye yatış maliyetleri analiz edilmiş ve komorbid hastalığı olan 532 COVID-19 hastasının tedavi maliyetleri üzerindeki etkileri belirlenmiştir.
Bulgular: 22.067 hasta örneklemine dayanan analiz sonuçları, ortalama hastanede yatış maliyetinin 1.432,3 $ [satın alma gücü paritesi (PPP) 4.994,7 $] olduğunu göstermiştir. Ortalama tedavi maliyeti erkek hastalar için daha yüksektir ve yaş ve yoğun bakım ünitesine yatışla birlikte artmaktadır. Ortalama hastanede yatış süresi 10,6 gün [standart deviasyon (SD) ±8,5] ve ortalama yoğun bakımda yatış süresi 9,9 (SD ±9,6) gündür. Ortalama günlük hastanede yatış maliyeti 2.067 hasta için 135,25 $’dir (PPP 471,63 $). Analizler, cinsiyet, yaş, yoğun bakım ünitesinde yatış ve miyokard enfarktüsü, serebrovasküler ve geçici iskemik ataklar, kronik obstrüktif akciğer hastalığı ve kronik böbrek hastalığı gibi komorbiditelerin COVID-19 hastalarının hastanede yatış maliyetlerini önemli ölçüde artırdığını göstermiştir.
Sonuç: COVID-19 ciddi hastalık ve ölüm oranlarına yol açan bir salgına sebep oldu. Salgınla mücadele sadece tıbbi açıdan değil salgının finansal sonuçları da göz önünde bulundurularak bütüncül bir yaklaşımla yapılmalıdır.
Anahtar Kelimeler: Komorbiditeler, COVID-19, yatış maliyeti, tedavi maliyetleri, Türkiye
Kaynakça
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