Yıl: 2021 Cilt: 6 Sayı: 3 Sayfa Aralığı: 531 - 537 Metin Dili: İngilizce DOI: 10.5336/healthsci.2020-77094 İndeks Tarihi: 17-02-2022

Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia

Öz:
Objective: Pneumonia is an indisputable cause of morbidity and mortality in elderly patients especially if they have dementia. We aimed to compare the cost of pneumonia for hospitalized patients with and without dementia and to investigate the factors affecting the direct cost of hospitalization. Material and Methods: The study group consisted of 58 dementia patients hospitalized for pneumonia compared with a matched cohort of 54 patients without dementia. The data were collected from the hospital record system between May 2017 and June 2019. Demographic features, comorbidities, characteristics of pneumonia and factors contributing to the total cost of hospitalization were analysed retrospectively. Results: The total mean cost of all patients for hospitalization of pneumonia was 653.1±1,059.9 American Dollars. The mean cost in the dementia group is 976.14±1,433.83 and 339.01±180.81 American Dollars for the control group per episode (p=0.001). The mean length of stay is 10.24±6.97 days and 7.24±2.89 days in the dementia and control groups, respectively (p<0.05). The number of consultations, pharmacy costs, examination costs and the total costs of patients with dementia were significantly higher than those without dementia and independent of the parameters associated with the characteristics of pneumonia. Conclusion: This study shows that pneumonia in elderly patients with dementia produces a burdensome financial cost which is lower in a matched population of patients without dementia. Advances in elderly care, precautions for pneumonia and assessment of aspiration risk in dementia patients might be rational solutions for decreasing the cost of pneumonia.
Anahtar Kelime:

Pnömoni Tanısı ile Hospitalize Edilen Demanslı Hastalarda Direkt Maliyetin Değerlendirilmesi

Öz:
Amaç: Pnömoni, özellikle yaşlı hastalarda tartışılmaz bir morbidite ve mortalite nedenidir. Çalışmamızın amacı, pnömoni tanısı ile hospitalize edilen demansı olan ve olmayan hastaların, hastanede yatış maliyetini karşılaştırmak ve direkt maliyete etki eden faktörleri değerlendirmektir. Gereç ve Yöntemler: Çalışmaya, pnömoni tanısı ile interne edilip, tedavi edilen demans tanılı 58 hasta ve benzer özellikteki demans tanısı olmayan 54 hasta dâhil edildi. Hastane kayıt sistemine Mayıs 2017 ile Haziran 2019 tarihleri arasında kaydedilen hasta verileri incelendi. Hastaların demografik özellikleri, komorbiditeleri, pnömoniye ait özellikler ve direkt hastane maliyetine etki eden faktörler retrospektif olarak değerlendirildi. Bulgular: Pnömoni tanısı ile hospitalize edilen hastaların toplam direkt maliyeti 653,1±1.059,9 Amerikan Doları olarak değerlendirildi. Demansı olan hastalarda, yatış başına ortalama maliyet 976,14±1.433,83 Amerikan Doları iken demansı olmayan hastalarda maliyetin 339,01±180,81 Amerikan Doları olduğu gözlendi (p=0,001). Ortalama yatış süresi demanslı hastalarda ve kontrol grubunda sırasıyla 10,24±6,97 gün ve 7,24±2,89 gün idi (p<0,05). Konsültasyon sayısı, ilaç maliyetleri, muayene ücretleri ve toplam maliyetin, demanslı hastalarda pnömoninin klinik özelliklerinden bağımsız olarak kontrol grubuna göre anlamlı ölçüde daha yüksek olduğu gözlendi. Sonuç: Bu çalışmanın sonuçları, pnömoni tanısı ile interne edilen demanslı hastaların, benzer özellikteki demansı olmayan hastalara göre anlamlı oranda fazla direkt finansal maliyeti olduğunu göstermiştir. Yaşlı bakımındaki gelişmeler, pnömoni gelişiminin önlenmesi için alınacak tedbirler ve aspirasyon riskinin değerlendirilmesi ile demanslı hastalarda aşırı maliyet yükünden kaçınılması mümkün olabilmektedir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement. 2013;9(1):63- 75.e2. [Crossref] [PubMed]
  • 2. Wimo A, Jönsson L, Bond J, Prince M, Winblad B; Alzheimer Disease International. The worldwide economic impact of dementia 2010. Alzheimers Dement. 2013;9(1):1-11.e3. [Crossref] [PubMed]
  • 3. Nair R, Haynes VS, Siadaty M, Patel NC, Fleisher AS, Van Amerongen D, et al. Retrospective assessment of patient characteristics and healthcare costs prior to a diagnosis of Alzheimer's disease in an administrative claims database. BMC Geriatr. 2018;18(1): 243. [Crossref] [PubMed] [PMC]
  • 4. Konomura K, Nagai H, Akazawa M. Economic burden of community-acquired pneumonia among elderly patients: a Japanese perspective. Pneumonia (Nathan). 2017;9:19. [Crossref] [PubMed] [PMC]
  • 5. Manabe T, Fujikura Y, Mizukami K, Akatsu H, Kudo K. Pneumonia-associated death in patients with dementia: a systematic review and meta-analysis. PLoS One. 2019;14(3): e0213825. [Crossref] [PubMed] [PMC]
  • 6. Bail K, Goss J, Draper B, Berry H, Karmel R, Gibson D. The cost of hospital-acquired complications for older people with and without dementia; a retrospective cohort study. BMC Health Serv Res. 2015;15:91. [Crossref] [PubMed] [PMC]
  • 7. Tichopad A, Roberts C, Gembula I, Hajek P, Skoczynska A, Hryniewicz W, et al. Clinical and economic burden of community-acquired pneumonia among adults in the Czech Republic, Hungary, Poland and Slovakia. PLoS One. 2013;8(8):e71375. [Crossref] [PubMed] [PMC]
  • 8. Lee JY, Yoo CG, Kim HJ, Jung KS, Yoo KH. Disease burden of pneumonia in Korean adults aged over 50 years stratified by age and underlying diseases. Korean J Intern Med. 2014;29(6):764-73. Erratum in: Korean J Intern Med. 2015;30(1):132. Erratum in: Korean J Intern Med. 2015;30(2):269. [Crossref] [PubMed] [PMC]
  • 9. Akyıl FT, Hazar A, Erdem İ, Öneş CP, Yalçınsoy M, Irmak İ, et al. Hospital treatment costs and factors affecting these costs in community-acquired pneumonia. Turk Thorac J. 2015;16(3):107-13. [Crossref] [PubMed] [PMC]
  • 10. Kosar F, Alici DE, Hacibedel B, Arpınar Yigitbas B, Golabi P, Cuhadaroglu C. Burden of community-acquired pneumonia in adults over 18 y of age. Hum Vaccin Immunother. 2017; 13(7):1673-80. [Crossref] [PubMed] [PMC]
  • 11. Verma AA, Guo Y, Kwan JL, Lapointe-Shaw L, Rawal S, Tang T, et al. Prevalence and costs of discharge diagnoses in inpatient general internal medicine: a multi-center cross-sectional study. J Gen Intern Med. 2018;33(11):1899- 904. [Crossref] [PubMed] [PMC]
  • 12. Goldfeld KS, Hamel MB, Mitchell SL. The cost-effectiveness of the decision to hospitalize nursing home residents with advanced dementia. J Pain Symptom Manage. 2013;46(5): 640-51. [Crossref] [PubMed] [PMC]
  • 13. Adachi M, Ishihara K, Abe S, Okuda K, Ishikawa T. Effect of professional oral health care on the elderly living in nursing homes. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(2):191-5. [Crossref] [PubMed]
  • 14. Schwendicke F, Stolpe M, Müller F. Professional oral health care for preventing nursing home-acquired pneumonia: a cost-effectiveness and value of information analysis. J Clin Periodontol. 2017;44(12):1236-44. [Crossref] [PubMed]
  • 15. Painter V, Le Couteur DG, Waite LM. Texturemodified food and fluids in dementia and residential aged care facilities. Clin Interv Aging. 2017;12:1193-203. [Crossref] [PubMed] [PMC]
  • 16. Takenoshita S, Kondo K, Okazaki K, Hirao A, Takayama K, Hirayama K, et al; Middle Western Japan-Dementia Study (mid-Dem study). Tube feeding decreases pneumonia rate in patients with severe dementia: comparison between pre- and post-intervention. BMC Geriatr. 2017;17(1):267. [Crossref] [PubMed] [PMC]
  • 17. Kumagai R, Kubokura M, Sano A, Shinomiya M, Ohta S, Ishibiki Y, et al. Clinical evaluation of percutaneous endoscopic gastrostomy tube feeding in Japanese patients with dementia. Psychiatry Clin Neurosci. 2012;66(5):418-22. [Crossref] [PubMed]
  • 18. Masaki S, Kawamoto T. Comparison of longterm outcomes between enteral nutrition via gastrostomy and total parenteral nutrition in older persons with dysphagia: a propensitymatched cohort study. PLoS One. 2019;14(10):e0217120. [Crossref] [PubMed] [PMC]
  • 19. Heo JY, Seo YB, Choi WS, Lee J, Noh JY, Jeong HW, et al. Cost-effectiveness of pneumococcal vaccination strategies for the elderly in Korea. PLoS One. 2017;12(5):e0177342. [Crossref] [PubMed] [PMC]
  • 20. Heo JY, Song JY, Noh JY, Choi MJ, Yoon JG, Lee SN, et al. Effects of influenza immunization on pneumonia in the elderly. Hum Vaccin Immunother. 2018;14(3):744-9. [Crossref] [PubMed] [PMC]
APA Yılmaz Kara B, OZCELIK N, ÖZYURT S (2021). Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia. , 531 - 537. 10.5336/healthsci.2020-77094
Chicago Yılmaz Kara Bilge,OZCELIK Neslihan,ÖZYURT SONGÜL Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia. (2021): 531 - 537. 10.5336/healthsci.2020-77094
MLA Yılmaz Kara Bilge,OZCELIK Neslihan,ÖZYURT SONGÜL Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia. , 2021, ss.531 - 537. 10.5336/healthsci.2020-77094
AMA Yılmaz Kara B,OZCELIK N,ÖZYURT S Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia. . 2021; 531 - 537. 10.5336/healthsci.2020-77094
Vancouver Yılmaz Kara B,OZCELIK N,ÖZYURT S Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia. . 2021; 531 - 537. 10.5336/healthsci.2020-77094
IEEE Yılmaz Kara B,OZCELIK N,ÖZYURT S "Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia." , ss.531 - 537, 2021. 10.5336/healthsci.2020-77094
ISNAD Yılmaz Kara, Bilge vd. "Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia". (2021), 531-537. https://doi.org/10.5336/healthsci.2020-77094
APA Yılmaz Kara B, OZCELIK N, ÖZYURT S (2021). Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia. Türkiye Klinikleri Sağlık Bilimleri Dergisi, 6(3), 531 - 537. 10.5336/healthsci.2020-77094
Chicago Yılmaz Kara Bilge,OZCELIK Neslihan,ÖZYURT SONGÜL Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia. Türkiye Klinikleri Sağlık Bilimleri Dergisi 6, no.3 (2021): 531 - 537. 10.5336/healthsci.2020-77094
MLA Yılmaz Kara Bilge,OZCELIK Neslihan,ÖZYURT SONGÜL Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia. Türkiye Klinikleri Sağlık Bilimleri Dergisi, vol.6, no.3, 2021, ss.531 - 537. 10.5336/healthsci.2020-77094
AMA Yılmaz Kara B,OZCELIK N,ÖZYURT S Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia. Türkiye Klinikleri Sağlık Bilimleri Dergisi. 2021; 6(3): 531 - 537. 10.5336/healthsci.2020-77094
Vancouver Yılmaz Kara B,OZCELIK N,ÖZYURT S Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia. Türkiye Klinikleri Sağlık Bilimleri Dergisi. 2021; 6(3): 531 - 537. 10.5336/healthsci.2020-77094
IEEE Yılmaz Kara B,OZCELIK N,ÖZYURT S "Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia." Türkiye Klinikleri Sağlık Bilimleri Dergisi, 6, ss.531 - 537, 2021. 10.5336/healthsci.2020-77094
ISNAD Yılmaz Kara, Bilge vd. "Evaluation of the Direct Cost in Patients with Dementia Hospitalized for Pneumonia". Türkiye Klinikleri Sağlık Bilimleri Dergisi 6/3 (2021), 531-537. https://doi.org/10.5336/healthsci.2020-77094