Üriner İnkontinansın Hastalık Yükü ve Maliyeti

Abstract

Üriner inkontinans (Üİ) fiziksel, ruhsal, sosyal ve ekonomik yönden tüm bireyleri olumsuz etkileyen bir sağlık sorunudur. Üİ görülme sıklığı %7-10 arasında değişmektedir. Üİ birey, aile, toplum ve sağlık hizmetleri üzerinde ciddi ekonomik yük oluşturmaktadır. Üİ ekonomik yükünün belirlenmesinde hastalık yükü önemli bir parametre olup, sıklıkla Kaliteye Ayarlanmış Yaşam Yılı - KAYY (Quality Adjusted Life Years-QALY) kullanmaktadır. Üİ maliyetleri kullanılan ve kaybedilen tüm maliyetleri kapsamakta olup, doğrudan ve dolaylı maliyetleri içermektedir. Doğrudan maliyetler; tanı, tedavi, rutin bakım ve Üİ sonuç maliyetleri içermekt olup rutin bakım maliyetleri Üİ maliyetlerinin büyük bir bölümünü oluşturmaktadır. Dolaylı maliyetler Üİ ekonomik yükünün görünmeyen yüzü olup hesaplanması oldukça zordur ve doğrudan maliyetlerden daha büyük bir paya sahip olduğu düşünülmektedir. Türkiye’de Üİ’nin hastalık ve ekonomik yüküne ilişkin bir kayıt sistemi veya araştırmaya rastlanmamış olup veriler Sağlık Uygulama Tebliği (SUT) kapsamında belirtilen tanı ve tedavi maliyetleri ile sınırlıdır. Bu derlemede üriner inkontinansın hastalık yükü ve maliyetinin literatür doğrultusunda incelenerek mevcut durumu belirlenmiştir. Yapılan çalışmalar doğrultusunda Üİ’nin birey ve sağlık sistemi üzerinde ciddi ekonomik yük oluşturduğu, birinci basamak sağlık hizmetlerinin bu maliyeti azaltmada önemli bir güç olacağı belirtilmektedir. Ülkemizde de Üİ’nin ulusal düzeydeki ekonomik yükünün belirlenmesi, doğrudan ve dolaylı maliyetlerin açığa çıkarılması, kaynakların doğru ve etkin şekilde kullanılması, maliyet-etkin inkontinans yönetimi açısından oldukça önemlidir.

Keywords

• Üriner inkontinans
• hastalık yükü
• maliyet

The Burden and Cost in Urinary Incontinence

Abstract

Urinary incontinence (UI) is a health problem that affects all individuals physically, mentally, socially and economically. The prevalence of UI ranges between 5-70%. UI creates a serious economic burden on the individual, family, community, and health services. Disease burden is an important parameter in determining the economic burden of UI and often uses Quality Adjusted Life Years (QALY-a tool developed to evaluate the cost-effectiveness of treatments). UI total cost cover all the costs used, lost and include direct and indirect costs. Direct costs consist of costs related to diagnosis, treatment, routine care, and UI outcome costs while routine care costs make up a large portion of UI costs. Indirect costs are the invisible portion of the economic burden of UI, which is very difficult to calculate and is assumed to have a larger share than direct costs. In Turkey, there is no registration system or research yet concerning the UI and its economic burden, and available data is limited to the costs of diagnosis and treatment specified in the Healthcare Implementation Communiqué (SUT). In this review, the disease burden and cost of stress (SUI), urgency (UUI), and mixed urinary incontinence (MUI) have been investigated according to the literature and its current status was determined. Our study has revealed that UI creates a serious economic burden on the individual and the healthcare system, and that first-line healthcare services are key in reducing this burden. For the cost-effective management of UI in Turkey, it is important to determine the economic burden of the disease at the national level, to expose relevant direct and indirect costs, and to employ resources accurately and effectively.

Keywords

• urinary incontinence
• disease burden
• cost

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