Comparative Analysis of the Cost of Insulin Treated Patients in Bulgaria

Doneva, Miglena; Valov, Vasil; Borisova, A M; Tankova, Tsvetalina; Savova, Alexandra; Manova, Manoela; Czech, Marcin; Petrova, Guenka

doi:10.5504/bbeq.2013.0001

Cited by 9 publications

(11 citation statements)

References 15 publications

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“…We were the first to introduce and develop the Bulgarian version of ADD-QoL-19 (ADDQoL-19 BUL). Although diabetes is known to be a serious burden on the Bulgarian public health system, the studies on the impact of diabetes on the patients' QoL are still scarce [32,[35][36][37][38][39]44].…”

Section: Resultsmentioning

confidence: 99%

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Bulgarian version of the Audit of Diabetes-Dependent Quality of Life (ADDQoL-19)

Levterova

Levterov²,

Dragova

et al. 2017

Biotechnology & Biotechnological Equipment

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The aims of this study were to translate and culturally adapt the UK English Audit of Diabetes-Dependent Quality of Life version 19 (ADDQOL-19) into Bulgarian and explore the psychometric properties of the ADDQoL-19 BUL. The formalized linguistic procedure was used to develop the Bulgarian version of the ADDQoL-19 BUL. The ADDQoL was assessed for the following: internal consistency (Cronbach's alpha); test-retest reliability (intraclass correlation coefficient (ICC)); factor structure and known-groups validity (insulin requiring vs. non-insulin requiring, with vs. without diabetes-related complications, overweight/obese vs. not overweight/obese). A total of 423 adults with type 2 diabetes mellitus (T2DM) participated in the study. The mean age was 59.92 years (standard deviation (SD) 11.60, range 28-88 years), and 52.6% were male. Internal consistency (a = 0.922) and the 3-week test-retest stability (intraclass correlation = 0.99) were high. Confirmatory factor analysis indicated that the one-factor structure of the ADDQoL-19 fits moderately (x 2 = 230.63, df = 136, p < 0.001, SRMR (Standardized Root Mean Square Residual) of 0.05, RMSEA (Root Mean Square Error of Approximation) of 0.06, CFI (Comparative Fit Index) of 0.95). Standardized coefficients showed that all domains loaded 0.4, except for one item. The total score was negatively associated with HbA 1 c (r = ¡0.10; p < 0.05), indicating that lower scores were related to poorer glycaemic control. In conclusion, the Bulgarian version of the ADDQoL-19 has good psychometric properties and provides clinicians and researchers with a useful tool for comprehensive assessment of the quality of life in adults with diabetes mellitus.

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Section: Resultsmentioning

confidence: 99%

“…Treatment of the disease is very expensive, but the real impact of diabetes is in the treatment of its complications. In Bulgaria, a growing number of patients with DM complicate the work of the health system because of limited financial resources [38,39].…”

Section: Introductionmentioning

confidence: 99%

Bulgarian version of the Audit of Diabetes-Dependent Quality of Life (ADDQoL-19)

Levterova

Levterov²,

Dragova

et al. 2017

Biotechnology & Biotechnological Equipment

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“…[20,21] In countries like Bulgaria, studies have confirmed that the main cost drivers are the medications for diabetes, outpatient medications for diabetes complications and the hospitalizations. [22] Regional differences are also observed in the cost of treatment deriving mostly from the patients' characteristics, therapy differences (type of insulin and oral anti-diabetes therapy) and social and economic status. [23] The objective of the present study was to identify and compare the hospitalizations cost due to micro-and macrovascular complications with the total cost of therapy for type 1 and type 2 diabetic individuals treated with insulin.…”

Section: Introductionmentioning

confidence: 99%

Cost of hospitalizations due to microvascular and macrovascular complications in type 1 and type 2 diabetic patients in Bulgaria

Dimitrova

Doneva

Valov³

et al. 2015

Biotechnology & Biotechnological Equipment

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The objective of this study was to evaluate the cost of hospitalizations due to micro-and macrovascular complications in an observed cohort of 433 patients with diabetes. A six-month combined retrospective and prospective observational study was performed. The patients were separated into two groups depending on the type of diabetes and further into subgroups depending on the reason for hospitalization. The total costs for each subgroup were calculated and compared to the total costs of treatment for the observed period. In the type 2 diabetes group (n D 255), there were 128 people with microvascular complications and 215 ones with macrovascular complications, whereas in the type 1 diabetes group, there were only 70 people out of 178 with microvascular complications and 72 ones with macrovascular complications. The total cost of hospitalizations in the type 2 diabetes group was 34 469.76 EUR with the following reported reasons for hospitalizations: poor control of diabetes (45%), microvascular complications (23%) and macrovascular complications (31%). In the type 1 diabetes group, the total hospitalizations cost was equal to 15 319.33 EUR with the following split: 59% due to poor control of diabetes, 22% due to microvascular complications and 19% due to macrovascular complications. Thus, type 2 diabetes is more costly than type 1 when hospitalizations occur. Type 2 diabetes is associated with higher cost of macrovascular complications than of microvascular ones probably due to high hypertension prevalence. Costs are paid by the health insurance fund and the differences need to be systematically revealed.

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“…Economic analysis on the treatment of chronic HBV infection shows that the average hospital cost per chronic case related to cirrhosis is 712 BGN ( 24 ). Cost analyses on the treatment of diabetes in Bulgaria show that the ambulatory cost per patient with diabetes on insulin analog therapy for a 6-month period is 652 BGN, which account for 46% of the total cost on average while the hospitalizations costs for complications due to diabetes are 23% of the total costs ( 27 ). Diabetes type 2 patients were associated with higher average cost per hospitalization due to complications (1,273 BGN) compared to patients with diabetes type 1 (933.26 BGN) ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

Chronic Hepatitis C-Related Cirrhosis Hospitalization Cost Analysis in Bulgaria

et al. 2017

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ObjectiveHCV infection is a leading cause of chronic liver disease with long-term complications—extensive fibrosis, cirrhosis, and hepatocellular carcinoma. The objective of this study is to perform cost analysis of therapy of patients with chronic HCV-related cirrhosis hospitalized in the University Hospital “Queen Joanna-ISUL” for 3-year period (2012–2014).MethodsIt is a prospective, real life observational study of 297 patients with chronic HCV infection and cirrhosis monitored in the University Hospital “Queen Joanna-ISUL” for 3-year period. Data on demographic, clinical characteristics, and health-care resources utilization (hospitalizations, highly specialized interventions, and pharmacotherapy) were collected. Micro-costing approach was applied to evaluate the total direct medical costs. The points of view are that of the National Health Insurance Fund (NHIF), hospital and the patients. Collected cost data are from the NHIF and hospitals tariffs, patients, and from the positive dug list for medicines prices. Descriptive statistics, chi-squared test, Kruskal–Wallis, and Friedman tests were used for statistical processing.Results76% of patients were male. 93% were diagnosed in grade Child-Pugh A and B. 97% reported complications, and almost all developed esophageal varices. During the 3 years observational period, patients did not change the critical clinical values for Child-Pugh status and therefore the group was considered as homogenous. 847 hospitalizations were recorded for 3 years period with average length of stay 17 days. The mortality rate of 6.90% was extremely high. The total direct medical costs for the observed cohort of patients for 3-year period accounted for 1,290,533 BGN (€659,839) with an average cost per patient 4,577 BGN (€2,340). Statistically significant correlation was observed between the total cost per patient from the different payers’ perspective and the Child-Pugh cirrhosis score.ConclusionHCV-related cirrhosis is resource demanding and sets high direct medical costs as it is related with increased hospitalizations and complications acquiring additional treatment.

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Comparative Analysis of the Cost of Insulin Treated Patients in Bulgaria

Cited by 9 publications

References 15 publications

Bulgarian version of the Audit of Diabetes-Dependent Quality of Life (ADDQoL-19)

Bulgarian version of the Audit of Diabetes-Dependent Quality of Life (ADDQoL-19)

Cost of hospitalizations due to microvascular and macrovascular complications in type 1 and type 2 diabetic patients in Bulgaria

Chronic Hepatitis C-Related Cirrhosis Hospitalization Cost Analysis in Bulgaria

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