KATARAKT CERRAHİSİ SONUÇLARININ DEĞERLENDİRİLMESİ: YAŞAM KALİTESİ, MALİYET VE KLİNİK ÖZELLİKLER ARASINDAKİ İLİŞKİ

Yıl 2024, Cilt: 27 Sayı: 1, 21 - 42, 27.03.2024

Demet Gökmen Kavak Yasemin Akbulut

https://doi.org/10.61859/hacettepesid.1321282

Öz

Türkiye’de ve dünyada görme engelliliğine neden olan en yaygın göz hastalıklarından birisi katarakttır ve tedavi amacıyla yaygın olarak uygulanan katarakt cerrahisi sayılarında giderek belirgin bir artış yaşanmaktadır. Bu durum katarakt cerrahisine yönelik sunulan hizmetlerin kalitesi ve maliyetine olan ilgiyi artırmaktadır. Bu araştırmanın amacı, katarakt cerrahisi öncesi ve sonrası sağlıkla ilişkili yaşam kalitesini belirlemek, katarakt cerrahisinin maliyetini hesaplamak, sosyo-demografik, klinik, ameliyat, hizmet sunucu, tedavi görülen klinik türü özellikleri ve maliyet ile sağlıkla ilişkili yaşam kalitesi arasındaki ilişkiyi incelemektir. Çalışma, prospektif, kesitsel türde ve analitik bir klinik alan araştırmasıdır. Çalışmaya, katarakt cerrahisi uygulanan, katarakta eşlik eden göz hastalığı bulunmayan, 18 yaş ve üstü, araştırmaya katılmaya gönüllü 363 hasta dâhil edilmiştir. Hastaların yaşam kalitesi verileri “Amerikan Ulusal Göz Sağlığı Enstitüsü Görme İşlevleri Anketi” ile katarakt cerrahisi maliyetine ilişkin veriler hasta faturalarından; klinik, ameliyat, hizmet sunucu özellikleri ve tedavi görülen klinik türüne yönelik veriler hasta dosyalarından toplanmıştır. Hastaların ameliyat sonrası yaşam kalitesi bileşik puan ortalaması (96,02±5,56), ameliyat öncesi yaşam kalitesi puan ortalamasına göre (82,77±11,89) daha yüksek bulunmuştur. Ameliyat sonrası yaşam kalitesi değişimi, ortalama 13,24 (±12,84) puan değerinde istatistiksel olarak anlamlı bir artış göstermektedir. Katarakt cerrahisi toplam maliyeti ile hastaların tedavi gördükleri klinik türleri arasında istatistiksel olarak anlamlı bir ilişki bulunmuştur. Katarakt cerrahisi toplam maliyeti ile hastaların klinik, ameliyat ve hizmet sunucu özellikleri ile ameliyat sonrası yaşam kalitesi değişimi arasında istatistiksel olarak anlamlı bir ilişki bulunmamaktadır. Katarakt cerrahisi hastaların yaşam kalitesini artırmaktadır. Katarakt cerrahisi hastalarının ameliyat öncesi ve ameliyat sonrası yaşam kalitesinin ölçülmesi, ameliyata uygunluğun belirlenmesi ve ameliyatın etkinliğinin izlenmesi açısından yararlı bilgiler sağladığından rutin hasta izlem sürecine dâhil edilebilir. Katarakt cerrahisi toplam maliyeti SUT paket fiyatının üstündedir. Katarakt cerrahisine yönelik paket fiyat uygulaması gözden geçirilerek, maliyetlerin kanıta dayalı olarak belirlenmesi değerlendirilebilir.

Anahtar Kelimeler

Katarakt Cerrahisi, Yaşam Kalitesi, Maliyet, Sağlık Sonuçları

Destekleyen Kurum

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Proje Numarası

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Teşekkür

Yazarlar çalışmaya gönüllü olarak katılan hastalara, hastanedeki sağlık çalışanlarına ve çalışmayı destekleyen hastane yönetim ekibine teşekkür eder.

EVALUATION OF CATARACT SURGERY RESULTS: THE RELATIONSHIP BETWEEN QUALITY OF LIFE, COST AND CLINICAL FEATURES

Öz

Cataract is one of the most common eye diseases that lead to visual impairment, not only in Turkey but also worldwide. There has been a significant increase in the number of cataract surgeries performed for treatment purposes. This increase has sparked interest in the quality and cost of services provided for cataract surgery. The aim of this study is to assess the health-related quality of life before and after cataract surgery, calculate the cost of cataract surgery, examine socio-demographic and characteristics, surgery details, service providers, and types of clinic involved, and explore the relationship between cost and health-related quality of life. The study is a prospective, cross-sectional and analytical clinical field study. It includes a total of 363 patients aged 18 years and older who underwent cataract surgery, did not have eye any accompanying eye diseases with their cataracts, and who volunteered to participate. Patient quality of life data of were collected using “American National Eye Health Institute Visual Functions Questionnaire”, while data on the cost of cataract surgery were derived from patient invoices. Information regarding clinic, surgery, service provider characteristics, and the type of clinic involved was obtained from patient records. The mean postoperative quality of life composite score of the patients (96.02±5.56) was found to be higher than the mean score of preoperative quality of life (82.77±11.89). The change in quality of life after surgery showed a statistically significant increase with a mean score of 13.24 (±12.84). A statistically significant correlation was observed between the total cost of cataract surgery and the types of clinics where patients were treated. However, there was no statistically significant relationship between the total cost of cataract surgery and the clinical, surgical and service provider characteristics of the patients and the change in the postoperative quality of life. Cataract surgery significantly improves the quality of life of patients. It can be integrated into routine patient follow-up processes as it provides valuable insights for measuring the preoperative and postoperative quality of life of cataract surgery patients, assessing their suitability for surgery, and monitoring the effectiveness of the procedure. Notably, the total cost of cataract surgery exceeds the SUT package price. An evidence-based approach to determining costs can be considered by reviewing the package pricing for cataract surgery.

Anahtar Kelimeler

Cataract Surgery, Quality of Life, Cost, Health Outcomes

Proje Numarası

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Kaynakça

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