A70318 CCG centres across the UK in an England/Scotland Lipohypertrohy Audit (ESLA) we developed a robust patient and HCP questionnaire that aimed to quantify the important role proper injection technique has in achieving and maintaining optimal glycemic control. A prospective, 3 visit audit study was conducted composed of 3 distinct phases: Study nurse training, patient recruitment, and finish study (patient exit). The primary endpoint was reduction in insulin usage. The secondary endpoint was reduction in HbA1c. These were comparted to baseline as well as modelled against a 13,000+ Injection Technique questionnaire to determine healthcare system savings and cost reductions. Results: The ESLA audits yielded an n of 75, and the ITQ yielded an n of 13,289. The results were comparable across both sample sizes. The prevalence of Lipohypertrophy was 50% on entry to the audit, and was reduced to 33% on exit. Mean insulin reduction related to ESLA ranged from 2 units per person per day to 17 units per person per day. ConClusions: Medical device value is materially impacted by the level of additional training and HCP support. The higher the training, the more aligned efficacy and effectiveness data become. This makes intuitive sense, as practice replicates the idea setting of a controlled trial. It is therefore highly recommended that additional training and HCP support be a key variable in the value assessment of medical devices.objeCtives: The unbalanced distribution of medical technologies and devices between rural and urban areas is a major problem for developing countries including Turkey. After the establishment of Public Hospital Unions (PHUs) in Turkey, legislative changes were made to improve the autonomy of public hospitals. This study utilizes spatial analysis to assess the distribution of medical device use in Turkey using PHUs as a decision making unit. Methods: Data from the PHUs' statistics year book for the year 2014 was assessed. The total number of PHUs is 89. A Hierarchical cluster analysis was performed to classify PHUs according to the total number of medical devices. The Euclidean distance measure and Wards methods were used in the analysis for classification. Results: Study results show that, in Turkey, PHUs were categorized into two clusters based on the total number of medical devices available. Regarding the spatial distribution of the clusters, the first cluster represents PHUs in rural areas, and the second represents PHUs located in urban areas of Turkey. PHUs representing large cities with high population density were included in one cluster, and all other PHUs were included in the second. Statistical test results indicated that the two clusters differ according to the total number of magnetic resonance imaging (MRI: t= -14.10, p< 0.01), computed tomography (CT) scan (t= -15.75, p< 0.01), mammography (t= -11.40, p< 0.01), ultrasonography (t= -14.62, p< 0.01), and electrocardiography (EKG; t= -12.29, p< 0.01) equipment available. ConClusions: It is advisable for health policy makers and heal...

Objectives: In the Turkish medical device industry, budgetary concerns usually overweight other crucial issues like quality and effectiveness of medical devices on clinical and economical outcomes. Reimbursement application and assessment principles have not been regulated until very recently by the Social Security Institution (SSI), the only competent authority for reimbursement. After productive communications and collaboration between SSI and industry, the new directive, "Procedures and Principles of Medical Device Applications" and its guideline "Medical Device Application" has been published by SSI on Apr, 20th 2016,Objective of this study is to describe reimbursement application and assessment procedures for Medical Devices and the critical points of the guideline and the directive. MethOds: The Directive and Guidelines dated 20.04.2016 are analyzed. Results: Ministry of Health (MoH) registration is a prerequisite for reimbursement in Turkey. All medical devices are subject to specialty-based positive listing, consisting of generic definitions and codes with corresponding ceiling reimbursement prices set by SSI. For inclusion into the positive lists, the manufacturer/ distributor has to submit a "reimbursement dossier" to SSI. To get a new reimbursement code for innovative, first-in-it-class products (Type A) and for product differentiation in terms of size or specifications (Type B); high-level clinical evidence and local health economics and budget-impact analyses are required. C and D type applications are for matching to an existing code and getting reimbursement approval for new barcodes of the already reimbursed products. cOnclusiOns: Local economic analysis and information on reimbursement status in reference countries may seem challenging to companies, due to lack of local data and difference between Turkish and reference countries' healthcare systems. However, longwaited Directive regulates the decision mechanism of SSI and provides opportunity of fair competition to the industry. It may be seen as an evidence indicating the mindset shift of SSI towards the value based approach.