Türkiye De Nuts Tr 5 Bölgesinde Esansiyel Hipertansiyon Tedavisinde Sosyal Güvenlik Kurumu Açısından Ilaç Kullanımı ve Tedavi Maliyetinin Retrospektif Veri Tabanı Analizi
Abstract
Essential hypertension has been the first disease to have the highest drug expenditures from the date of constitution of Social Security Institution. In Turkey, Ministry of Health is aiming to treat and control essential hypertension in primary care units. This study’s main objective is to analyse the costs of the drugs prescribed in primary healthcare units located at Ankara, Konya, Karaman (NUTS TR 5) between the years 2008-11. Also the adherence of prescribed drugs to the contemporary guidelines has been explored. The data are derived from the database of Social Security Institution (SSI) of Turkey, which is the sole authority for reimbursement of drugs and health care costs of the almost whole population. Then we used a sample of 500 individuals for findings that we have to follow the patients’ whole treatment protocol. We analysed the individuals’ prescriptions who are selected for our sample for their adherence to the guidelines, and their costs and the change of costs with the age, sex and co-morbidities. In conclusion, we found that essential hypertension’s prevalence was higher in women and in the elderly, combination therapy was the most used therapy in Turkey, the first concomitant disease for essential hypertension was hyperlipidemia, patients who had changed their drugs during the therapy and patients whose prescriptions were not adhering to the guidelines had mean costs higher than the mean costs calculated for the same year. Within the framework of these findings, we made some recommendations to the SSI and Ministry of Health to improve the system and the practice.
Keywords: Essential hypertension, primary health care, reimbursement mechanisms, retrospective study.