هزينه‌هاي مستقيم بيماري ديابت نوع دو تحت پوشش بيمه خدمات درماني و تامين اجتماعي تا پايان سطح يك خدمات براي سازمان‌هاي بيمه‌گر و بيماران در شهرستان ايلام در سال 1397

Direct Costs of Type 2 Diabetes for Insurance Companies and Patients Covered by Health Insurance and Social Security Insurance Plans after the Delivery of First-Level Services in Ilam, Iran in 2019

مقدمه: پيامدهاي مالي ناشي از افزايش شيوع ديابت در كشورها نشان مي‌دهد كه ديابت يكي از چالش‌هاي اصلي سيستم سلامت است. لذا هدف از مطالعه‌‌ي حاضر، بررسي هزينه‌هاي مستقيم ارائه خدمات (تا پايان سطح يك خدمات) به مبتلايان به ديابت نوع دو، كه تحت پوشش بيمه خدمات درماني و تامين اجتماعي بودند،براي سازمان‌هاي بيمه‌گر و بيماران در شهرستان ايلام، در سال 1397 بود. مواد و روش‌ها: مطالعه‌ي حاضر يك پژوهش توصيفي-تحليلي است. جامعه هدف شامل تمامي مبتلايان به ديابت نوع دو ساكن شهرستان ايلام، داراي پرونده‌ي الكترونيك در مراكز جامع سلامت و تحت پوشش مراكز بيمه‌اي بودند. نمونه‌گيري به‌صورت سرشماري، و ابزار گردآوري داده‌ها چك ‌ليست بود. داده‌ها با استفاده از نرم‌افزار SPSS20، با آزمون‌هاي آمار استنباطي (تي مستقل، آناليز واريانس يك طرفه) و آمار توصيفي (ميانگين و انحراف معيار) تجزيه ‌و تحليل شدند. يافته‌ها: هشتصد بيمار وارد مطالعه شدند كه %71/4 آن‌ها زن بودند. ميانگين سني بيماران به ترتيب 59/42 و 54/97 براي مرد و زن بود. ميانگين هزينه‌هاي مستقيم سالانه براي هر فرد 62742383 ريال برآورد شد. بيشترين هزينه مربوط به هزينه‌هاي بستري آن ­ها؛ برابر با 49794297 ريال (79/3درصد) و كمترين هزينه مربوط به تصويربرداري و برابر با 673148 ريال (1 درصد) بود. بين هزينه‌هاي مستقيم با جنسيت، سن، وضعيت تأهل، تحصيلات، شغل، مدت ابتلا، نمايه توده بدني، نوع بيمه‌ و فشار خون ارتباط معني‌داري وجود نداشت (0/05

Introduction: The financial consequences of the increasing prevalence of diabetes show that diabetes is one of the main challenges of healthcare systems. This study aimed to investigate the direct costs imposed on insurance companies and patients by the delivery of first-level services to patients with type 2 diabetes, who were covered by health insurance and social security insurance plans in Ilam, Iran, in 2019. Materials and Methods: In this descriptive analytical study, the population included all patients with type 2 diabetes, who had available electronic records in comprehensive health centers and were covered by the insurance companies of Ilam. The data collection tool was a checklist, and data analysis was performed in SPSS version 20. Inferential statistics, including independent t-test and one-way analysis of variance, were measured, and descriptive statistics, including mean and standard deviation, were calculated. Results: A total of 800 patients entered this study, 71.4% of whom were female. The mean age of male and female patients was 59.42 and 54.97 years, respectively. The average annual direct cost was estimated at 62,742,383 Rials per person; the highest cost was related to hospitalization (49,794,297 Rials) (79.3%), and the lowest cost was related to imaging (673,148 Rials) (1%). There was no significant relationship between the direct costs and gender, age, marital status, education, occupation, duration of disease, body mass index (BMI), type of insurance, or blood pressure (P<0.05). Conclusion: According to the findings of this study, diabetes imposes a significant financial burden on the healthcare system, including significant hospitalization and medication costs. The majority of patients were covered by health insurance, and the financial burden was significant for individuals and governments. Therefore, elimination of predisposing factors for the disease and optimal management can reduce the imposed costs on healthcare systems.