Fakülteler / Faculties
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Item Assessment of the Direct Medical Costs of Type 2 Diabetes Mellitus and its Complications in Turkey(2014) Malhan, Simten; Oksuz, Ergun; Babineaux, Steven M.; Ertekin, Ali; Palmer, James P.; 0000-0002-5723-5965; K-8238-2012Purpose: To estimate the direct annual medical costs of Type 2 diabetes and its complications in diagnosed patients in Turkey. Material and Method: A cost-of-illness model was developed. The prevalence of Type 2 diabetes was derived from the Turkish Diabetes Epidemiology Study, estimated as 13.7% in adults, with one-third of patients previously undiagnosed. Complication costs were extracted from the records of 7095 patients at a Turkish tertiary care hospital in 2009. For each modelled complication, acute phase costs were applied to globally derived incidence rates, and one-year follow-up costs were applied to globally derived prevalence rates. Costs and frequencies of ongoing antihyperglycaemic treatment and disease management were derived from treatment guidelines and Turkish hospital records. Parameter variation was performed. Results: The cost of Type 2 diabetes in diagnosed patients was estimated at between 11.4 to 12.9 billion Turkish Lira, 1% of Gross Domestic Product. Cardiovascular complications comprised the largest share of total medical costs (between 24.3% and 32.6%), followed by renal complicationsrelated costs (between 25% and 28.3%) and concomitant cardiovascular and antihypertensive medication costs (between 14.2% and 16%). Antihyperglycaemic medications and screening costs comprised between 10.9% to 12.3% and between 4.4% to 5% of total costs, respectively. Discussion: Type 2 diabetes is a disease burden and economic burden in Turkey; the complications cost is higher than the cost of disease control. For preventing complications, any activities effect positively limited resources and also quality of life.Item Evaluation of the Methods Used for the Vital Signs Measurement in Hospitalized Patients(2018) Numanoglu, Rukiye; Kocak, Onur; Malhan, Simten; Oksuz, Ergun; 0000-0002-5723-5965; K-8238-2012In general, vital signs measurements which includes measurement of blood pressure, body temperature, pulse and oxygen levels provide very important information about the health status of the hospitalized patients and the effects of treatment. Measurements and documentation of the vital signs carried out by nurses at hospitals. In this study, the methods used in vital signs measurements of hospitalized patients were evaluated by observations and interviews at a foundation university hospital and the advantages and disadvantages of the existing technologies were determined. As a result of interviews with healthcare providers and observations, it was determined that vital signs measurements of hospitalized patients were performed by 2 different methods. The mean time of vital signs measurements were determined as 3 minutes and 4 seconds (SD: 00:31) in medical treatment patients, 2 minutes and 11 seconds (SD: 00:18) in surgical patients, and 2 minutes and 37 seconds (SD: 00:37) in all patients. It was determined that the measurement results were recorded in the patient physical file in an average of 1 minute 2 seconds (SD: 00:52) and it was revealed that 15% of the measurement records were wrong, 26.9% were delayed and 10.6% were not recorded which performed by the nurses. It was also determined that the measurement results were not included in the hospital information system. It is thought that vital findings will provide important data for artificial intelligence studies in the following period with the recording of the results of the measurement to the electronic environment.Item Patient Characteristics And Management Practices In Chronic Myeloid Leukemia In Turkey: Reflections From An Expert Meeting(2022) Eskazan, Ahmet Emre; Ali, Ridvan; Alnigenis, Ebru; Ayyildiz, Orhan; Haznedaroglu, Ibrahim; Kirkizlar, Onur; Kurtoglu, Erdal; Malhan, Simten; Oksuz, Ergun; https://orcid.org/0000-0002-5723-5965; 35184657; K-8238-2012Introduction The therapeutic landscape of chronic myeloid leukemia (CML) has evolved significantly since the introduction of imatinib. The European LeukemiaNet (ELN) recommendations serve as a guide for diagnosis, treatment, and monitorization of CML, but availability and accessibility of diagnostic tools and medications affect their applicability. Areas covered This article provides an overview of the current clinical management of CML in Turkey with reference to the key outputs of the online expert meeting held in November 2020. The applicability of the ELN 2020 recommendations for treating CML in clinical practice was also discussed. Expert opinion Imatinib is the only reimbursed and the most preferred first-line treatment in CML restricting the upfront use of second-generation tyrosine kinase inhibitors (TKIs), thereby limiting the applicability of treatment-free remission approach in Turkey. The ELN recommendations about using the EUTOS Long-Term Survival (ELTS) score for risk assessment and focusing on patient reported outcomes and quality of life can be enhanced with educational activities. The widespread availability of standardized technical infrastructure for diagnosing and monitoring CML will contribute to better disease management. Establishing a sustainable national database for CML is valuable for observing patient characteristics and disease outcomes as well as the impact of treatment patterns over time.Item Efficacy and Cost-Effectivity Analysis of Outpatient Parenteral Antimicrobial Therapy Unit in Infectious Disease Clinical Practices: Turkey Perspective(2021) Bastug, Aliye; Oksuz, Ergun; Kazancioglu, Sumeyye; Malhan, Simten; Ozbay, Bahadir Orkun; Bodur, Hurrem; 0000-0002-5723-5965; 33709495; K-8238-2012Background Outpatient parenteral antimicrobial treatment (OPAT) has become a common treatment modality in developed countries. OPAT units are not widespread in Turkey, and their cost-effectivity analysis has not been studied, yet. Aims To analyze the clinical efficacy and cost-effectiveness of the OPAT unit, based on a 1000-bed teaching hospital. Methods The records of patients, who were treated between October 2013 and December 2017, in an OPAT unit of a tertiary hospital in Ankara, were obtained retrospectively. The cost that would arise if the patients were hospitalized for the same treatment period with the same diagnosis was calculated and compared with the actual treatment cost of the patients in the OPAT unit. Results A total of 594 patients who received antimicrobial treatment at the OPAT unit were enrolled. The mean age of the patients was 55.39 +/- 16.37 years and 313 (52.7%) were males. Based on the end-of-treatment goals, 98.5% of the patients reached the treatment goal. An indirect cost analysis revealed that the OPAT unit was 487.625 94 TL/129.008 78 $ less costly than inpatient parenteral antibiotic treatment. In other words, OPAT cost was 75% of the equivalent inpatient costs. It was also determined that a total of 7078 bed days and 11.9 bed days per person were saved. Conclusions OPAT units should be expanded increasingly in Turkey. The evaluation together with the health care system conditions in Turkey revealed that the OPAT program is safe, effective, and cost-efficient.Item Economic Burden Of Lung Cancer In Turkey: A Cost Of Illness Study From Payer Perspective(2021) Cicin, Irfan; Oksuz, Ergun; Karadurmus, Nuri Nuri; Malhan, Simten; Gumus, Mahmut; Yilmaz, Ulku; Cansever, Levent; Cinarka, Halit; Cetinkaya, Erdogan; Kiyik, Murat; Ozet, Ahmet; 0000-0002-5723-5965; 34173876; K-8238-2012Background This study was designed to estimate economic burden of lung cancer in Turkey from payer perspective based on expert panel opinion on practice patterns in clinical practice. Methods In this cost of illness study, direct medical cost was calculated based on cost items related to outpatient visits, laboratory and radiological tests, hospitalizations/interventions, drug treatment, adverse events and metastasis. Indirect cost was calculated based on lost productivity due to early retirement, morbidity and premature death resulting from the illness, the value of lost productivity due to time spent by family caregivers and cost of formal caregivers. Results Cost analysis revealed the total per patient annual direct medical cost for small cell lung cancer to be euro8772), for non-small-cell lung cancer to be euro10,167. Total annual direct medical cost was euro497.9 million, total annual indirect medical cost was euro1.1 billion and total economic burden of lung cancer was euro1.6 billion. Hospitalization/interventions (41%) and indirect costs (68.6%) were the major cost drivers for total direct costs and the overall economic burden of lung cancer, respectively. Conclusions Our findings indicate per patient direct medical costs of small cell lung cancer and non-small-cell lung cancer to be substantial and comparable, indicating the substantial economic burden of lung cancer in terms of both direct and indirect costs. Our findings indicate that hospitalization/interventions cost item and indirect costs were the major cost drivers for total direct costs and the overall economic burden of lung cancer, respectively. Our findings emphasize the potential role of improved cancer prevention and early diagnosis strategies, by enabling cost savings related to drug treatment and metastasis management cost items, in sustainability of cancer treatments.