P4.14: Financial burden of critically-ill patients receiving parenteral nutrition (PN) in a reference intensive care unit (ICU) in Istanbul: An additional cost from Syrian refugees

Abstract

Introduction: The number of critically-ill patients has increased over the years due to progress in intensive care medicine and parenteral nutrition (PN) techniques. Long-term survival is possible and does not depend only primarily on the disease etiology (head trauma and pulmonary complications etc.) but on accompanying morbidities and complications such as central venous catheter infections. Prolonged ICU admissions are costly as well. Therefore, covering the cost of these critical patients (primary disease treatment including interventional and surgical issues, all consultations and treatment protocols) is an important issue, and having health insurance coverage for their treatment and all of the needed follow-up care (including almost 4 millions Syrian refugees, as well) is critical. Methods: A computer-based analysis was done retrospectively to search the covering health insurance programmes of our patients treated in our adult ICUs during January to December 2018. Syrian refuees were also included in the study, as state insurance coverage was supplied to all. Other then known government-issued general health insurance, private health insurance options and the payments done by the patients’ own resources were also interrogated. Results: A total of 186 patients were included in the study. Mean age was 51 years (range, 18–91). The average period of ICU stay was 45 days (range, 1–204), including longer hospitalization time due to surgical complications or existing comorbidities. The postoperative stay in intensive care unit (ICU) was also included in this period. In our data, the only health insurance coverage was seen to be supplied by the state (n=186, 100 %). There was no private insurance coverage. No patients used their own financial resources for treatment, as well (including Syrian refugees). Conclusion: It is well-known that state insurance in Turkey covers all policlinic applications and postdischarge home care (including all refugees), and patients pay only a small amount of fee as employee contribution for the medications at pharmacies. The new information in the present study is the governmental coverage of all Syrian refugees in ICUs, as well. Taking the great amount of bill that an ICU patient should encounter, the importance of state insurance is obvious for the comfort of patient and the ease of financial portion of their treatment.