Kalıcı tünelli veya geçici hemodiyaliz kateteri ile rutin hemodiyaliz programında olan hasta grubunda kateter tipine göre Maliyet-Etkinlik araştırması

Yıl 2022, , 392 - 396, 27.09.2022

Asiye Aslı Gözüaçık Rüzgar Engin Akgül , Abdulkerim Özhan , Selim Durmaz , Cenk Aslan Hakan Öntaş

https://doi.org/10.18663/tjcl.1063274

Öz

ÖZET
Amaç: Bu çalışmamızda hemodiyaliz kateteri takılarak rutin hemodiyaliz programına dahil edilen hastaların kateterlerinin aktif kullanılabildiği günleri tespit edip, kateter maliyetlerinin de belirlenerek kateter çeşidine göre maliyet/etkinlik araştırması yapmayı amaçladık.

Gereç ve Yöntem: 2013-2020 tarihleri arasında geçici hemodiyaliz kateteri takılan hastalar (Grup 1) ve tünelli hemodiyaliz kateteri takılanlar (Grup 2) hastane arşivi taranarak tespit edildi. Bir sonraki kateter takılma tarihlerine göre kateterlerin aktif kullanıldığı gün sayısı hesaplandı. Ardından hastane muhasebe servisinden güncel sağlık uygulamaları tebliğine göre devletin kalıcı ve geçici kateterler için ödediği ücret tespit edildi. SPSS 22 programı kullanılarak gün başına düşen kateter maliyeti belirlendi.

Bulgular: Demografik özelliklere göre yapılan incelemede gruplar arasında cinsiyet açısından anlamlı farklılık tespit edilmedi (p=0.129). Hastalardaki yaş ortalamasına bakıldığında gruplar arasında farklılık bulunmadı (p=0.085). Diyabet, hipertansiyon ve koroner arter hastalığı açısından yapılan değerlendirmede de gruplar arasında istatistiksel farklılık bulunmadı (p=0,219, p=0,129, p=0,822). Grup 2 de açık kalma süreleri anlamlı olarak yüksek idi ( p<0.001). Kateterlerin yerleştirilme bölgesi olarak Grup 1 için en çok femoral (p<0.001), Grup 2 için ise juguler (p<0.001) bölgenin tercih edildiği görülmüştür. Birim gün başına düşen kateter maliyeti hesaplandığında ise Grup 1 in anlamlı oranda daha az maliyetli olduğu anlaşılmıştır (p=0.031).

Sonuç: Geçici hemodiyaliz kateterleri kalıcı tünelli hemodiyaliz kataterlerine göre maliyet etkin ürünlerdir.
Anahtar Kelimeler:Hemodializ katateri maliyet/etkinlik,Geçici hemodializ katateri, Kalıcı tünelli hemodializ katateri,Femoral ven, Juguler ven

Anahtar Kelimeler

Hemodializ katateri maliyet/etkinlik, Geçici hemodializ katateri, Kalıcı tünelli hemodializ katateri, Femoral ven, Juguler ven

Cost-Effectiveness research according to the type of catheter in the group of patients on routine hemodialysis program with permanent tunneled or temporary hemodialysis catheters

Öz

Abstract
Background:
In this study, our aim was to conduct a cost/effectiveness research by determining the cost , in the patients who are in the routine hemodialysis program with a hemodialysis catheter, according to type of the catheter and the number of the days in which the catheters can be used actively.
Methods:
Between 2013 and 2020,patients with temporary hemodialysis catheters (Group 1 , n:81) and patients tunneled hemodialysis catheters (Group 2, n:205) were identified by scanning the hospital archive. The number of days in which the catheters were actively used was calculated according to the next catheter insertion or replacement date. Then, the permanent and temporary catheter fees paid by the governmentdetermined, according to the current Health Practices Communique (SUT) pricing that learnt from the hospital accounting department. Catheter cost per day was determined using the SPSS 22 program.
Results:
In the analysis made according to demographic characteristics, no significant difference was found between the groups in terms of gender (p=0.129). When the mean age of the patients was examined, no difference was found between the groups (p=0.085). No statistical difference was found between the groups in comorbid conditions: diabetes, hypertension, and coronary artery disease (p=0.219, p=0.129, p=0.822). The patency period was significantly higher in group 2 (p<0.001). It was observed that the femoral (p<0.001) region was preferred most for Group 1 patients and the jugular region (p<0.001) for Group 2 patients as the placement site of the catheters. When the catheter cost per unit day was calculated, it was understood that Group 1 was significantly less costly (p=0.031).
Conclusion:
Temporary hemodialysis catheters are cost/effective products compared to permanent tunneled catheters.
Keywords:
Hemodialysis catheter cost/effectiveness,Temporary hemodialysis catheter, Permanent tunneled hemodialysis catheter,Femoral vein, Jugular vein

Anahtar Kelimeler

Keywords:Hemodialysis catheter cost/effectiveness, Temporary hemodialysis catheter, Permanent tunneled hemodialysis catheter, Femoral vein, Jugular vein

Kaynakça

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