COVID-19 TANILI HASTALARDA TABURCULUK KRİTERİ DEĞİŞİKLİĞİNİN TEDAVİ SONUCU VE MALİYETE ETKİSİ

Öz

Haziran 2020 tarihinde normalleşme sürecine geçilmesi ile koronavirüs hastalığı-2019 (COVID-19) tedavisi tamamlanan hastaların tedavi sonrası polimeraz zincir reaksiyonu testi negatifliği beklenmeden taburcu edilmesi kararı alınmıştır. Bu çalışmada uygulama öncesi ve uygulama sonrası birer aylık periyotlardaki hasta profili, hastanede yatış süresi ve maliyetin karşılaştırılması planlandı. 15 Haziran 2020 öncesi (birinci grup) ve sonrası (ikinci grup) birer aylık süreçlerde pandemi servisinde COVID-19 olası ve kesin tanısı ile takip edilen hastaların demografik verileri, ko-morbiditeleri, laboratuvar bulguları, tedavi, prognoz ve tedavi maliyetleri karşılaştırıldı. Çalışmaya birinci gruptan 46, ikinci gruptan 49 olmak üzere toplam 95 hasta dâhil edildi. Birinci grupta kesin vaka oranı %37 iken bu oran ikinci grupta %59’du (p=0.040).Kesin vaka tanımına uyan hastalarda birinci grubun hastanede yatış süresi ortancası ikinci gruba göre daha uzundu (Grup 1 için;10 (3-21), Grup 2 için; 6 (3-12) gün, p=0.003). İkinci gruptaki hastalarda COVID-19 ile uyumlu tipik tomografi bulgu oranı daha yüksekti (Grup 2 için %52 ve Grup 1 için%26, p=0.018). İlk grupta hidroksiklorokin ile tedavi oranı ikinci gruba göre daha yüksek iken (Grup 1 için %72 ve Grup 2 için %41, p=0.004) ikinci grupta favipiravir ile tedavi oranı daha fazla idi (Grup 2 için %55 ve Grup 1 için %17, p=0.001). Birinci grupta tedavi maliyeti ortancası 2798 (661-45465) TürkLirası(TL), ikinci grupta ise 1627 (748-4496) TL idi (p=0.001). COVID-19 tanılı hastaların tedavi sonrası izolasyon sürelerini hastane dışında tamamlaması hastane maliyetinin azaltılması açısından anlamlıdır.

Anahtar Kelimeler

• COVID-19
• hastane maliyeti
• SARS-COV-2
• prognoz

THE EFFECT OF CHANGE IN DISCHARGE CRITERIA ON PROGNOSIS AND COST IN PATIENTS WITH COVID-19

Öz

With the transition to the normalization process on June, 2020, it was decided to discharge the patients who completed the coronavirus disease 2019 (COVID-19) treatment without waiting for polymerase chain reaction test negativity. In this study, it was planned to compare the patient profile, length of hospital stays and cost in one-month periods before and after the decision. Demographic data, co-morbidities, laboratory findings, treatment, prognosis and treatment costs of the patients who were followed up with a probable and definitive diagnosis of COVID-19 in the pandemic service in the one-month period before 15 June 2020 (first group) and after (second group) were compared. A total of 95 patients, 46 from the first group and 49 from the second group, were included in the study. The definitive case rate in the first group was 37%, while this rate was 59% in the second group (p=0.040). The median length of hospital stay of the first group was longer than the second group 10 (3-21) days’ vs 6 (3-12) days p=0.003) in patients who confirm the definitive case definition. The rate of typical tomography findings compatible with COVID-19 was higher in the patients in the second group (52% for second group and 26% for first group) (p=0.018). While the rate of treatment with hydroxychloroquine was higher in the first group than in the second group (72% for the first group and 41% for the second group) (p=0.004), the rate of treatment with favipiravir was higher in the second group (55% for the second group and 17% for the first group) (p=0.001). The median treatment cost was 2798 (661-45465) Turkish liras (TL) in the first group and 1627 (748-4496) TL in the second group (p=0.001). It is significant in terms of reducing hospital costs that patients with a diagnosis of COVID-19 complete their post-treatment isolation period outside the hospital.

Anahtar Kelimeler

• COVID-19
• SARS-COV-2
• hospital cost
• prognosis

Kaynakça

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