Ozdemir Tarkan, Kilic Hatice, Yilmaz Demirci Nilgun, Ozdilekcan Cigdem, Bektemur Guven, Turkkani Mustafa Hamidullah, Malhan Simten, Hasanoglu H Canan, Koc Orhan, Ozturk Can
Department of Chest Diseases, Dr. Abdurrahman Yurtaslan Ankara Oncology Research and Training Hospital, University of Health Sciences, Ankara, Turkey.
Department of Chest Diseases, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey.
Turk Thorac J. 2021 Sep;22(5):393-398. doi: 10.5152/TurkThoracJ.2021.19150.
Chronic obstructive pulmonary disease (COPD) is one of the major causes of mortality and morbidity worldwide. The aim of this study was to reveal the trend in direct costs related to COPD between 2012 and 2016, and to evaluate hospital costs in 2016, together with their subcomponents.
A population-based descriptive study was conducted using administrative healthcare data in Turkey. The total direct cost of COPD diagnosis-treatment for each year from 2012 to 2016, was calculated. The distribution of the hospital's COPDrelated costs for the year 2016 was also examined, together with morbidity data.
The direct costs of the patients who were admitted to step 1, step 2, and step 3 health care centers between 2012 and 2016 increased by 41% [895 041 403TL ($496 930 501) in 2012 to 1 263 288 269TL ($417 834 197) in 2016]; the increase was 60% and 24%, for inpatient and outpatient groups respectively. In the year 2016, the direct total cost was 1003TL ($332) per patient. In 2016, mean specialist consultations per patient with mean cost per specialist consultation, and mean emergency visits per patient with mean cost per emergency visit, were 1.7, 42 TL ($14), and 0.4, 71TL ($23) respectively. For the inpatient group, the mean number of hospitalizations per patient, mean number of hospitalization days, and the mean cost per hospitalization were 0.4, 6.5, and 1926TL ($637), respectively.
When the readmissions of patients with COPD were evaluated together with the costs, and compared with the statistics from other countries, it was found that the costs per patient were lower in Turkey. However, the reasons for the significant rise in inpatient costs compared to outpatient costs should be investigated. Further investigations are required regarding pulmonary rehabilitation, home health care services, preventive measures for infections, management of comorbidities, and treatment optimization, which may reduce hospitalizations.
慢性阻塞性肺疾病（COPD）是全球主要的死亡和发病原因之一。本研究的目的是揭示2012年至2016年期间与COPD相关的直接成本趋势，并评估2016年的医院成本及其子组成部分。
利用土耳其的行政医疗数据进行了一项基于人群的描述性研究。计算了2012年至2016年每年COPD诊断治疗的总直接成本。还检查了2016年医院与COPD相关成本的分布情况以及发病数据。
2012年至2016年期间，在一级、二级和三级医疗保健中心就诊的患者的直接成本增加了41%[2012年为895041403土耳其里拉（496930501美元），2016年为1263288269土耳其里拉（417834197美元）]；住院患者和门诊患者组的增幅分别为60%和24%。2016年，每位患者的直接总成本为1003土耳其里拉（332美元）。2016年，每位患者的平均专科会诊次数及每次专科会诊的平均成本，以及每位患者的平均急诊就诊次数及每次急诊就诊的平均成本，分别为1.7次、42土耳其里拉（14美元）和0.4次、71土耳其里拉（23美元）。对于住院患者组，每位患者的平均住院次数、平均住院天数和每次住院的平均成本分别为0.4次、6.5天和1926土耳其里拉（637美元）。
当将COPD患者的再入院情况与成本一起评估，并与其他国家的统计数据进行比较时，发现土耳其每位患者的成本较低。然而，应调查住院成本相比门诊成本显著上升的原因。关于肺康复、家庭医疗服务、感染预防措施、合并症管理和治疗优化等方面需要进一步研究，这些措施可能会减少住院次数。
