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Öğe Impact of Rational Laboratory Practice on Hospital Procedure Costs Based on Evidence-Based Medicine: Case Study in a University Hospital(Duzce Univ, Fac Medicine, 2022) Kaplan, Zekeriya; Bozdemir, EnverObjective: By integrating the rational laboratory system into hospital processes with evidenc-ebased medicine applications, it is ensured that hospital resources are used more effectively and efficiently by preventing unnecessary test requests and reducing laboratory operation costs. Methods: The data in this qualitative study are the primary data and were obtained through document review and focus group (physician) interviews. The data in question were analyzed comparatively before the Rational Laboratory Application (RLA) (between 01.06.2018-31.12.2018) and after the RLA (between 01.06.2019-31.12.2019). The universe of the study consists of all the data in the laboratory of Deizce University Health Application and Research Center Hospital (DUHARCH). In this universe, the data evaluated for rational laboratory application constitute the sample of the research. Results: Before the RLA, a total of 446,300 test requests were made in the seven months (in 2018) and the cost of these tests was determined to be 1,591,063 (sic) ($ 330,782.33). After the RLA, a total of 475,585 test requests were made in the seven months (in 2019), and the cost of these tests was determined to be 1,537,903 (sic) ($ 271,235.10). It was found that after RLA, there was a 6.56% increase in the number of examination requests compared to before RLA, but as an amount, costs fell by 3.34% on a (sic) basis and 22% on a $ basis. In the unit-based analysis, it was seen that successful units were surgical, and unsuccessful units were internal units that requested more tests. Conclusions: It was concluded that the rational laboratory system based on evidence-based medicine reduces hospital processing costs, provided that patient safety is protected, so this method can be a tool for more effective and efficient use of hospital resources.Öğe Kanıta dayalı tıp ile akılcı laboratuvar kullanım yönteminin hastane işlem maliyetleri üzerindeki etkisi: Bir üniversite hastanesi uygulama örneği(Düzce Üniversitesi, 2020) Kaplan, Zekeriya; Bozdemir, EnverAmaç: Kanıta dayalı tıp uygulamalarıyla ile akılcı laboratuvar sistemini hastane süreçlerine entegre ederek gereksiz tetkik istemlerinin önüne geçmek, laboratuvar işlem maliyetlerini düşürmek ve hastane kaynaklarını daha etkin ve verimli kullanmayı sağlamak amaçlanmıştır. Yöntem: Çalışmada veri toplama yöntemi olarak birincil veri toplama tekniği kullanılmıştır. Bu tekniğe bağlı olarak nitel araştırma tekniği kullanılarak doküman incelemesi ve odak grup görüşmeleri (hekim görüşmeleri) yapılmıştır. Çalışmanın evreni Düzce Üniversitesi Sağlık Uygulama ve Araştırma Merkezi (Hastanesi)'nin laboratuvardaki tüm verilerden oluşurken bu evren içerisinde akılcı laboratuvar uygulaması için değerlendirilen veriler ise araştırmanın örneklemini oluşturmaktadır. Çalışmanın amacına uygun olarak söz konusu veriler, Akılcı Laboratuvar Uygulaması (ALU) öncesi (01.06.2018-31.12.2018 tarihleri arası) ve ALU sonrası (01.06.2019-31.12.2019 tarihleri arası) olarak karşılaştırmalı olarak verilmiştir. Bulgular: ALU öncesi 7 aylık dönemde toplam 446.300 adet tetkik istemi yapılmış ve bu tetkiklerin maliyeti 1.591.063 TL olarak görülmüştür. ALU sonrası 7 aylık dönemde ise toplam 475.585 adet tetkik istemi yapılmış ve bu tetkiklerin maliyeti 1.537.903 TL olarak görülmüştür. ALU öncesi ve sonrası tetkik istem sayıları oranlandığında ise %6,56 artışın olduğu, fakat tutar olarak oranlandığında ise %3,34 oranında maliyetlerin düştüğü tespit edilmiştir. Tetkik istem sayıları artmış olmasına rağmen, tetkik tutarlarının azaldığı tespit edilmiştir. İstem sayıları artan tetkiklerin fiyatlarının düşük, istem sayıları azalan tetkiklerin fiyatlarının yüksek olduğu görülmüştür. Birimlere tetkik istem sayıları açısından bakıldığında 30 birimden 13 (%43,3) tanesinde istem sayıları düşerek başarılı olduğu görülmektedir. Tetkik istem sayıları beklenenin aksine yükselerek başarısız olan birim sayısı ise 17 (%56,67)'dir. Birimlere tetkik maliyet açısından bakıldığında 30 birimden 18 (%60) tanesinde maliyetler düşerek başarılı olduğu görülmektedir. Maliyetleri beklenenin aksine yükselerek başarısız olan birim sayısı ise 12 (%40)' dir. Başarılı olan birimlerin ağırlıklı olarak cerrahi birimler olduğu, başarısız olan birimlerin ise daha çok tahlil isteyen dâhili birimler olduğu görülmüştür. Sonuç: Hasta güvenliğini korumak şartıyla kanıta dayalı tıp ekseninde yapılan uygulanan akılcı laboratuvar sisteminin hastane işlem maliyetlerini azalttığı bu nedenle bu yöntemin hastane kaynaklarının daha etkin ve verimli kullanılabilmesinde bir araç olabileceği sonucuna varılmıştır.Öğe Treatment Cost Analysis of COVID-19 in patients Treated at a University Hospital in Turkey(Duzce Univ, Fac Medicine, 2021) Bozdemir, Enver; Balbay, Öner Abidin; Terzi, Melek; Kaplan, ZekeriyaObjective: To guide both the hospital management and the health policymakers who play a role in the management process of their disease by analysing the costs of the patients receiving inpatient treatment in Diizce University Health Application and Research Center (Hospital - DUHARH) due to coronavirus disease 2019 (COVID-19) from the perspective of the Social Security Institution (SSI). Methods: The study covers 582 patients who received inpatient treatment in intensive care and other clinics in March/2020-December/2020 due to COVID-19 disease in DUHARH. In the study, all sample unselected populations were included. Retrospectively obtained data were analysed using bottom-up, document analysis, and multivariate regression analysis. Results: It was determined that 60% of the 582 patients studied were male (350 people), 40% female (232 people) and that the average hospitalization period was 5.7 days, 23% (134 people) in the Pandemic Intensive Care Unit and 77% (448 people) in other pandemic services. The total amount invoiced to SSI by the hospital was 7.378.695,00 TRY ($ 1,052,595). It was determined that 79% of this was the intervention cost and the average daily hospitalization cost per patient was +/- 2,099.80 TRY ($ 299.54). Besides, since gender discrimination is male, elderly patients are hospitalized in intensive care. The hospitalization period is P<0.05. It was observed that medicine, material, intervention, and examination costs have increased. Conclusions: In the study conducted, it was observed that the increase in men, age and hospitalization period, and treatment in intensive care increased the costs, and among these, the intervention costs were the highest. To reduce the cost of illness, it is necessary to use lower-cost factors to eliminate the disease rate with restrictions and ultimately to vaccinate the whole population as soon as possible.Öğe Treatment cost of chest diseases during the COVID-19 pandemic: Case analysis at the Duzce University Hospital(Turkish Assoc Tuberculosis & Thorax, 2022) Bozdemir, Enver; Balbay, Ege Güleç; Sahin, Dilek; Balbay, Öner Abidin; Annakkaya, Ali Nihat; Kaplan, ZekeriyaIntroduction: The aim of the study was to determine the cost of Coronavirus disease-19 (COVID-19) patients who were treated as outpatients and inpatients at Duzce University Health Application and Research Center (DUHARH) Chest Diseases Clinic before and after the pandemic from the perspective of the Social Security Institution (SSI). Materials and Methods: The study included 26.438 patients who applied to the Chest Diseases clinic in DUHARH before the COVID-19 pandemic (March 10 2019-March 10 2020) and after (March 11 2020-March 11 2021) and 2.971 patients who were hospitalized in the service. A sample was not selected in the research, and the entire universe was included in the study. The data obtained retrospectively were analyzed from bottom to top and through document analysis management. Frequency and percentage calculations, Spearman Correlation analysis, and Mann-Whitney U tests were used to evaluate the data. Results: Before the COVID-19 pandemic, the average unit cost in the policlinic was 46.14 TL/patient ($8.14/patient), and the average unit cost was 64.69 TL/ patient ($9.23/patient) after the COVID-19 pandemic. The average cost of the pre-COVID-19 pandemic service was calculated as 1.139,64 TL/patient ($200/patient). After the COVID-19 pandemic, the average unit cost in the service was 2.136,27 TL/patient ($.304.75/patient). A statistically significant difference in terms of costs was found between the two periods. It was determined that the costs of COVID-19 patients changed in terms of length of stay, age, and sex (p< 0.05). Conclusion: Even though the number of patients in the Chest Diseases clinic has decreased during the pandemic process, the costs have increased due to the high cost of COVID-19 patients and the patients needing advanced examination and treatment in this period. For this reason, patients need to apply to the relevant unit early.
