A general view to costs for the hospitalized patients in palliative care unit: A single centre experience
Abstract
Purpose: Palliative care can be defined shortly as an approach that aims to improve the quality of life for life-threating conditions. Recently, the numbers of palliative care units raised, and there is a lack of detailed knowledge about the costs. The present study purposed to investigate the group of costs in the palliative care unit.
Material and Method: The retrospective study conducted the archive records of 333 inpateints’ costs in Kırıkkale Üniversitesi, School of Medicine, İbn-i Sina Palliative Care Unit between March 2019- December 2019. The cost groups were defined as medications, laboratory investigations, radiological procedures, medical equipment, and others.
Results: Between the main groups, the most expensive group was medications, and the most expensive medications were antibiotics.
Conclusion: Defining expenses may be important for the correct use of palliative care and well-planning. The fact that drugs and especially antibiotic expenses are at the forefront can emphasize the importance of rational drug use.
Keywords
References
- 1. Lorenz KA, Lynn J, Dy SM, et al. Evidence for improving palliative care at the end of life: A systematic review. Ann Intern Med. 2008;148(2):147-159. doi:10.7326/0003-4819-148-2-200801150-00010 2. Aslan Y. Türkiye’de ve Dünya’da Palyatif Bakım Modellerine Genel Bakış. Anadolu Güncel Tıp Derg. 2020; 2(1): 19-27. 3. Kabalak AA. Türkiye'de Palyatif Bakım; 2014, Güncel Gelişmeler, Gereksinimler. Anestezi Dergisi 2014; 22 (3): 121 - 123 4. Lynch T, Connor S, Clark D. Mapping levels of palliative care development: A global update. J Pain Symptom Manage. 2013;45(6):1094-1106. doi:10.1016/j.jpainsymman.2012.05.011 5. Ozgul N, Gultekin M, Koc O, et al. Turkish community-based palliative care model: a unique design. Ann Oncol. 2012;23 Suppl 3:76-78. doi:10.1093/annonc/mds093 6. Mathew C, Hsu AT, Prentice M, et al. Economic evaluations of palliative care models: A systematic review. Palliat Med. 2020;34(1):69-82. doi:10.1177/0269216319875906 7. Ağır H, TırAğ H, Anabilim Dalı İ. Türkiye’de Sağlık Harcama Türlerinin Değerlendirilmesi Kahramanmaraş Sütçü İmam Üniversitesi Sosyal Bilimler Derg 2018;15(2):643-670 8. Mosoiu D, Dumitrescu M, Connor SR. Developing a costing framework for palliative care services. J Pain Symptom Manage. 2014;48(4):719-729. doi:10.1016/j.jpainsymman.2013.11.017 9. Chan ATC, Jacobs P, Yeo W, et al. The cost of palliative care for hepatocellular carcinoma in Hong Kong. Pharmacoeconomics. 2001;19(9):947-953. doi:10.2165/00019053-200119090-00006 10. Guest JF, Ruiz FJ, Greener MJ, Trotman IF. Palliative care treatment patterns and associated costs of healthcare resource use for specific advanced cancer patients in the UK. Eur J Cancer Care (Engl). 2006;15(1):65-73. doi:10.1111/j.1365-2354.2005.00623.x 11. Hacıevliyagil S, Mutlu L. Göğüs hastalıkları servisine yatan hastaların hastane yatış maliyetlerinin karşılaştırılması. Toraks Derg. 2006;7(1):11-16. 12. Dagli O, Tasdemir E, Ulutasdemir N. Palliative care infections and antibiotic cost: a vicious circle. Aging Male. 2019;0(0):1-8. doi:10.1080/13685538.2019.1575353 13. Pereira J, Watanabe S, Wolch G. A retrospective review of the frequency of infections and patterns of antibiotic utilization on a palliative care unit. J Pain Symptom Manage. 1998;16(6):374-381. doi:10.1016/s0885-3924(98)00093-1 14. Ertuğrul MB, Özgün H, Saylak MÖ, Sayım N. Antibiotic Use and Its Cost in Surgical Clinics of a University Hospital: A One-Day Point Prevalence Survey. Klimik Derg. 2009;22(2):44-47. 15. Vitetta L, Kenner D, Sali A. Bacterial infections in terminally ill hospice patients. J Pain Symptom Manage. 2000;20(5):326-334. doi:10.1016/s0885-3924(00)00189-5 16. Albrecht JS, McGregor JC, Fromme EK, Bearden DT, Furuno JP. A nationwide analysis of antibiotic use in hospice care in the final week of life. J Pain Symptom Manage. 2013;46(4):483-490. doi:10.1016/j.jpainsymman.2012.09.010 17. White PH, Kuhlenschmidt HL, Vancura BG, Navari RM. Antimicrobial use in patients with advanced cancer receiving hospice care. J Pain Symptom Manage. 2003;25(5):438-443. doi:10.1016/s0885-3924(03)00040-x 18. Reinbolt RE, Shenk AM, White PH, Navari RM. Symptomatic treatment of infections in patients with advanced cancer receiving hospice care. J Pain Symptom Manage. 2005;30(2):175-182. doi:10.1016/j.jpainsymman.2005.03.006 19. Macedo F, Nunes C, Ladeira K, et al. Antimicrobial therapy in palliative care: an overview. Support Care Cancer. 2018;26(5):1361-1367. doi:10.1007/s00520-018-4090-8 20. Marcus E, Clarfield AM, Moses AE. Ethical Issues Relating to the Use of Antimicrobial Therapy in Older Adults. Clin Infect Dis. 2001;33(10):1697-1705. doi:10.1086/323757 21. Prigerson HG, Bao Y, Shah MA, et al. Chemotherapy use, performance status, and quality of life at the end of life. JAMA Oncol. 2015;1(6):778-784. doi:10.1001/jamaoncol.2015.2378
Abstract
Amaç: Palyatif bakım, yaşamı tehdit eden hastalarda yaşam kalitesinin artırmayı hedefleyen yaklaşım olarak özetlenebilir. Ülkemizde palyatif bakım ünitelerinin sayısı son zamanlarda artmış olup, harcamalarıyla ilgili ayrıntılı veri bulunmamaktadır. Bu çalışmada hastanemiz palyatif bakım ünitesindeki harcama gruplarının belirlenmesi amaçlanmıştır.
Gereç ve Yöntem: Kırıkkale Üniversitesi, Tıp Fakültesi, İbn-i Sina Palyatif Bakım Ünitesi’nde Mart 2019- Aralık 2019 arasında yatan 333 hasta yatışının arşiv kaydı hasta harcamaları açısından retrospektif olarak incelendi. Gruplar; ilaçlar, laboratuvar incelemeleri, radyolojik inceleme ve girişimler, tıbbi malzemeler ve diğer harcamalar olarak gruplandı.
Bulgular: Gruplar arasında en pahalı harcama türü ilaç ve medikal tedaviydi. İlaçların içerisinde de en pahalı grubun antibiyotikler olması dikkati çekti.
Sonuç: Palyatif bakımın doğru kullanımı ve düzgün planlama için giderlerin belirlenmesi önemli olabilir. İlaç ve özellikle antibiyotik giderlerinin ön planda olması akılcı ilaç kullanımının önemini vurgulayabilir.
Keywords
References
- 1. Lorenz KA, Lynn J, Dy SM, et al. Evidence for improving palliative care at the end of life: A systematic review. Ann Intern Med. 2008;148(2):147-159. doi:10.7326/0003-4819-148-2-200801150-00010 2. Aslan Y. Türkiye’de ve Dünya’da Palyatif Bakım Modellerine Genel Bakış. Anadolu Güncel Tıp Derg. 2020; 2(1): 19-27. 3. Kabalak AA. Türkiye'de Palyatif Bakım; 2014, Güncel Gelişmeler, Gereksinimler. Anestezi Dergisi 2014; 22 (3): 121 - 123 4. Lynch T, Connor S, Clark D. Mapping levels of palliative care development: A global update. J Pain Symptom Manage. 2013;45(6):1094-1106. doi:10.1016/j.jpainsymman.2012.05.011 5. Ozgul N, Gultekin M, Koc O, et al. Turkish community-based palliative care model: a unique design. Ann Oncol. 2012;23 Suppl 3:76-78. doi:10.1093/annonc/mds093 6. Mathew C, Hsu AT, Prentice M, et al. Economic evaluations of palliative care models: A systematic review. Palliat Med. 2020;34(1):69-82. doi:10.1177/0269216319875906 7. Ağır H, TırAğ H, Anabilim Dalı İ. Türkiye’de Sağlık Harcama Türlerinin Değerlendirilmesi Kahramanmaraş Sütçü İmam Üniversitesi Sosyal Bilimler Derg 2018;15(2):643-670 8. Mosoiu D, Dumitrescu M, Connor SR. Developing a costing framework for palliative care services. J Pain Symptom Manage. 2014;48(4):719-729. doi:10.1016/j.jpainsymman.2013.11.017 9. Chan ATC, Jacobs P, Yeo W, et al. The cost of palliative care for hepatocellular carcinoma in Hong Kong. Pharmacoeconomics. 2001;19(9):947-953. doi:10.2165/00019053-200119090-00006 10. Guest JF, Ruiz FJ, Greener MJ, Trotman IF. Palliative care treatment patterns and associated costs of healthcare resource use for specific advanced cancer patients in the UK. Eur J Cancer Care (Engl). 2006;15(1):65-73. doi:10.1111/j.1365-2354.2005.00623.x 11. Hacıevliyagil S, Mutlu L. Göğüs hastalıkları servisine yatan hastaların hastane yatış maliyetlerinin karşılaştırılması. Toraks Derg. 2006;7(1):11-16. 12. Dagli O, Tasdemir E, Ulutasdemir N. Palliative care infections and antibiotic cost: a vicious circle. Aging Male. 2019;0(0):1-8. doi:10.1080/13685538.2019.1575353 13. Pereira J, Watanabe S, Wolch G. A retrospective review of the frequency of infections and patterns of antibiotic utilization on a palliative care unit. J Pain Symptom Manage. 1998;16(6):374-381. doi:10.1016/s0885-3924(98)00093-1 14. Ertuğrul MB, Özgün H, Saylak MÖ, Sayım N. Antibiotic Use and Its Cost in Surgical Clinics of a University Hospital: A One-Day Point Prevalence Survey. Klimik Derg. 2009;22(2):44-47. 15. Vitetta L, Kenner D, Sali A. Bacterial infections in terminally ill hospice patients. J Pain Symptom Manage. 2000;20(5):326-334. doi:10.1016/s0885-3924(00)00189-5 16. Albrecht JS, McGregor JC, Fromme EK, Bearden DT, Furuno JP. A nationwide analysis of antibiotic use in hospice care in the final week of life. J Pain Symptom Manage. 2013;46(4):483-490. doi:10.1016/j.jpainsymman.2012.09.010 17. White PH, Kuhlenschmidt HL, Vancura BG, Navari RM. Antimicrobial use in patients with advanced cancer receiving hospice care. J Pain Symptom Manage. 2003;25(5):438-443. doi:10.1016/s0885-3924(03)00040-x 18. Reinbolt RE, Shenk AM, White PH, Navari RM. Symptomatic treatment of infections in patients with advanced cancer receiving hospice care. J Pain Symptom Manage. 2005;30(2):175-182. doi:10.1016/j.jpainsymman.2005.03.006 19. Macedo F, Nunes C, Ladeira K, et al. Antimicrobial therapy in palliative care: an overview. Support Care Cancer. 2018;26(5):1361-1367. doi:10.1007/s00520-018-4090-8 20. Marcus E, Clarfield AM, Moses AE. Ethical Issues Relating to the Use of Antimicrobial Therapy in Older Adults. Clin Infect Dis. 2001;33(10):1697-1705. doi:10.1086/323757 21. Prigerson HG, Bao Y, Shah MA, et al. Chemotherapy use, performance status, and quality of life at the end of life. JAMA Oncol. 2015;1(6):778-784. doi:10.1001/jamaoncol.2015.2378
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original research article |
| Authors | |
| Publication Date | August 31, 2020 |
| Submission Date | March 9, 2020 |
| Published in Issue | Year 2020 |