Retrospective Analysis of Multiple Sclerosis Patients’ Records in a Reference Hospital Center

Abstract

Objective: This study aims to identify sociodemographic and hospitalization characteristics of the multiple sclerosis (MS) patients admitted to a reference center in Turkey. Patients and Methods: This is a single-center retrospective study which reviews MS patient records in 66 months. The study covered between April 1, 2010 and September 30, 2015. Data was collected on age, gender, number of admissions, number of hospitalizations (dates and durations), requests for laboratory tests and Magnetic Resonance Imaging (MRI), existence of disability reports and provision of home care. Total number of admissions for home care was 78. Results: We determined 6996 MS admissions by 1578 patients in 66 months. 65.8% (n: 1038) of patients were females; mean age was 37.0. There were 4.4 admissions per patient. 584 (37.0%) patients had MRI requests. Blood tests were requested in 25% of all admissions. We identified 5213 (74.5%) admissions of 400 (25.3%) patients who have admitted at least five times to the center. For this group, mean admission per patient was 13.0, MRI request per patient was 2.1. 38.7% (n=152) of these patients was hospitalized at least once. Conclusion: The use of resources for MS patients in a hospital setting is remarkable, which includes admissions, hospitalizations, blood tests and MRIs. However, when the number of patients with MS diagnosis taken into consideration, it is noteworthy that the number of demands for homecare is very small. Our study will be a guide for reducing cost of illness and improving care pathways.

Keywords

• Multiple sclerosis,sociodemographic charcateristics,hospitalization,Turkey

References

1. 1. Kurt S, Karaer H, Kaplan Y. A case diagnosed with multiple sclerosis in advanced age. Fırat Med J. 2009;14:293-6.
2. 2. Borazan H, Kartal E, Telcioğlu Ş. Multiple sclerosis anesthesia in a patient. Selcuk Medical Journal. 2007; 23: 95-8.
3. 3. Akpınar Z, Akca H. Immunopathology of multiple sclerosis. Selcuk Med J 2007;24:99-102.
4. 4. Eraksoy M. Multipl skleroz ve diğer miyelin hastalıklar. In: Emre M, ed. Nöroloji temel kitabı, 1st edn. Güneş tıp kitapevi, Ankara, 2013:1111-41.
5. 5. Compston A, McDonald I, Noseworthy J,et al. In: Compston A, Confavreux C, Lassman H, Miller D, McDonald I, Noseworthy J, Smith K, Werkerle H, eds. McAlpine’s Multiple Sclerosis, 4th edn. Edinburgh: Churchill Livingstone/Elsevier, 2005.
6. 6. Lublin F, Miller AE. Multiple Sclerosis and other inflammatory demyelinating diseases of the central nervous system. In: Bradley WG, Daroff RB, Fenichel GM, Jancovic J, eds. Neurology in Clinical Practice, 5th edn. Butterworth Heinnemann Elsevier, 2010.
7. 7. Nusrat S, Levinthal D, Bielefeldt K. Hospitalization rates and discharge status in multiple sclerosis. Multiple Sclerosis Int. 2013; Article ID 436929, http://dx.doi.org/10.1155/2013/436929.
8. 8. Akkuş Y, Kapucu S. Multiple sclerosis and patient education. Nursing J. 2006;15:57–63.

9. 9. Mutluay F. Rehabilitation in multiple sclerosis. Med J Neurol. 2006;12:134-43.
10. 10. Johansson S, Ytterberg C, Gottberg K, Holmqvist LW, Koch von L. Use of health services in people with multiple sclerosis with and without fatigue. Multiple sclerosis. 2009;15:88-95.
11. 11. Ministry of Health, World Multiple Sclerosis Day 2015 Report newsletter. Available at: [e-mail] (Accessed 31 May 2016)
12. 12. Onat SS, Delialioğlu SU, Ozisler Z, Ozel S. Demographic and clinical features of hospitalized multiple sclerosis patients undergoing a rehabilitation program at our clinic. Turk J Physic Med Rehab 2015;61.1:23. Academic One File. (Accessed 31 May 2016)
13. 13. Alp R, Alp SI, Plancı Y, Yapıcı Z, Börü UT. The prevalence of multiple sclerosis in the north caucasus region of Turkey: door-to-door epidemiological field study multipl skleroz prevelansı: Türkiye’nin kuzey doğusunda epidemiyolojik saha çalışması. Arch Neuropsychiatr. 2012;49:272-5.
14. 14. Er F, Mollaoğlu M. Disability and activities of daily living in the patients with multiple sclerosis. J Neurol Sci. 2011;28:190-203.
15. 15. Marrie RA, Elliot L, Marriott J, et al. Dramatically changing rates and reasons for hospitalization in multiple sclerosis. Neurology. 2014;83:937- 39.
16. 16. Bourdette DN, Prochazka AV, Mitchell W, et al. Health care costs of veterans with multiple sclerosis: implications for the rehabilitation of MS. Arch Phys Med Rehabil. 1993;74:26–31.
17. 17. Gumus H, Akpınar Z, Yılmaz H. Multipl sklerozun kadın cinselliği üzerine etkileri: Kontrollü çalışma. J Sex Med. 2014;11:481-5.
18. 18. Inman RP. Disability indices, the economic costs of illness, and social insurance: the case of multiple sclerosis. Acta Neurol Scand Suppl. 1984; 70: 46–55.
19. 19. Catanzaro M, Weinert C. Economic status of families living with multiple sclerosis. Int J Rehab Res. 1992;15:209–18.
20. 20. Weinfeld FD, Baum HM. The national multiple sclerosis survey: background and economic impact. Ann NY Acad Sci 1984;436:469–71.
21. 21. Holmes J, Madwick T, Bates D. The cost of multiple sclerosis. Br J Med Econ. 1995;8:181–93.
22. 22. Orlewska E, Mierzejewski P, Zaborski J, et al. A prospective study of the financial costs of multiple sclerosis at different stages of the disease. Eur J Neurol. 2005;12:31-39.
23. 23. Taylor B, McDonald E, Fantino B, et al. The cost of multiple sclerosis in Australia. J Clin Neurosc. 2007;14:532-39.
24. 24. Karabudak R, Karampampa K, Calışkan Z. Treatment experience, burden and unmet needs in MS study: Results from Turkey. J Med Econom. 2015;18: 69-75.
25. 25. Prime Ministry general directorate of legislative development and publication. regulation on home care services. Ankara, 10 March 2015; official newspaper: No: 25751 (Başbakanlık Mevzuatı Geliştirme ve Yayın Genel Müdürlüğü. Evde Bakım Hizmetleri Sunumu Hakkında Yönetmelik.Ankara, 10 March 2005; Resmi Gazete: Sayı 25751.) Available at: http://www.saglik.gov.tr/TR/belge/1-570/evde-bakimhizmetleri-sunumuhakkinda-yonetmelik.html (Accessed 7 June 2016).)
26. 26. Yılmaz M, Sametoğlu F, Akmeşe G, et al. Sağlık hizmetinin alternatif bir sunum şekli olarak evde hasta bakımı. In-home health services as an alternative form of presentation of patient care. İstanbul Tıp Derg - Istanbul Med J. 2010;11:125-32.