Investigation of Out-of-Pocket Health Expenditures, Quality of Life and Medication Adherence Levels of Patients with Type 2 Diabetes

Yıl 2025, Cilt: 13 Sayı: 2, 373 - 391, 31.07.2025

Rahime Nur Demir , Özgür Uğurluoğlu

https://doi.org/10.22139/jobs.1671323

Öz

The aim of this research is to determine the factors affecting the out-of-pocket health expenditures of patients diagnosed with type 2 diabetes, primarily quality of life and medication adherence. The research data were collected by questionnaire method from patients diagnosed with type 2 diabetes who applied to the internal medicine outpatient clinic of a public hospital operating in Bayburt. In this study, diabetes patients were easily selected by sampling and 350 type 2 diabetes patients were reached. The first part of the questionnaire includes sociodemographic information about the patients, the second part includes questions about out-of-pocket health expenditures of the patients, the third part includes the “SF-12 Quality of Life” scale, and the fourth part includes the “Medication Adherence Report Scale (MARS)” scale. The data obtained in this study were examined with SPSS 27.0 software and multivariate regression analysis was conducted.As a result of the research, it was determined that the annual average out-of-pocket expenditure of type 2 diabetes patients was 5,374 TL and that 66.34% of these expenditures were for private consumption food, 11.06% for private devices, 10.09% for non-prescription drugs, 6.81% for medicine, 3.37% for private health services, 1.88% for transportation, and 0.41% for examination co-payment. In addition, it has been found that out-of-pocket health expenses increase with a decrease in patients' mental quality of life and medication adherence levels. In addition, it has been found that the number of hospital admissions, the duration of illness, the presence of a family history of diabetes, being on a special diet related to diabetes, and gender are other important determinants of out-of-pocket health expenditures in patients with type 2 diabetes. According to the results obtained from the research findings, it is recommended that special nutrition, special tools, medicines and treatment costs should be covered more broadly within the scope of insurance in order to reduce out-of-pocket expenses of patients with diabetes. In addition, it is thought that the organization of education and awareness programs aimed at improving medication adherence and health-related quality of life in patients with diabetes will contribute to reducing out-of-pocket health expenses.

Anahtar Kelimeler

Out-Of-Pocket Expenses , Type 2 Diabetes , Quality of Life , Medication Adherence

Tip 2 Diyabet Tanılı Hastaların Cepten Sağlık Harcamaları, Yaşam Kaliteleri ve İlaca Uyum Düzeylerinin İncelenmesi

Öz

Bu araştırmanın amacı tip 2 diyabet tanılı hastaların cepten sağlık harcamalarını etkileyen, başta yaşam kalitesi ile ilaca uyum olmak üzere, faktörleri belirlemektir. Araştırma verileri Bayburt’ta faaliyet gösteren bir kamu hastanesi dahiliye polikliniğe başvuru yapan tip 2 diyabet tanılı hastalardan anket yöntemiyle toplanmıştır. Bu çalışmada diyabet hastaları kolayda örnekleme yoluyla seçilmiş olup 350 tip 2 diyabet hastasına ulaşılmıştır. Anket formunun ilk bölümünde hastalara ait sosyodemografik bilgiler, ikinci bölümde hastaların cepten sağlık harcamalarına ait sorular, üçüncü bölümde “SF-12 Yaşam Kalitesi” ölçeği, dördüncü bölümde “Medication Adherence Report Scale (MARS)” ölçeği yer almaktadır. Bu çalışmada elde edilen veriler, SPSS 27.0 yazılımıyla incelenmiş olup çok değişkenli regresyon analizi yürütülmüştür. Araştırma sonucunda tip 2 diyabet hastalarının yıllık ortalama cepten harcamasının 5.374 TL olduğu ve bu harcamaların %66,34’ünün özel tüketim besin, %11,06’sının özel alet, %10,09’unun reçetesiz ilaç, %6,81 ilaç, %3,37’sinin özel sağlık hizmeti, %1,88’inin ulaşım, %0,41’inin muayene katkı payı olduğu tespit edilmiştir. Ayrıca hastaların mental sağlık yaşam kalitesi ve ilaca uyum düzeylerinin azalmasıyla cepten sağlık harcamalarının arttığı tespit edilmiştir. Bunun yanında hastaneye yapılan başvuru sayısının, hastalık süresinin, ailede diyabet hikayesi varlığının, diyabete bağlı özel bir diyet yapıyor olmanın ve cinsiyetin tip 2 diyabetli hastalarda cepten yapılan sağlık harcamasın önemli diğer belirleyicileri olduğu bulunmuştur. Araştırma bulgularından elde edilen sonuçlar doğrultusunda diyabetli hastaların cepten harcamalarını azaltmak için özel beslenme, özel alet, ilaç ve tedavi masraflarının sigorta kapsamında daha geniş şekilde karşılanması gerektiği önerilmektedir. Bunun yanı sıra, diyabetli hastalarda ilaca uyumu ve sağlıkla ilgili yaşam kalitesini artırmaya yönelik eğitim ve farkındalık programlarının düzenlenmesinin cepten sağlık harcamalarının azaltılmasına katkı sağlayacağı düşünülmektedir.

Anahtar Kelimeler

Cepten Harcama , Tip 2 Diyabet , Yaşam Kalitesi , İlaç Uyumu

Kaynakça

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