Analiza kosztów miesięcznej terapii chorób przewlekłych, zaleconej po okresie hospitalizacji, prowadzonej w warunkach opieki ambulatoryjnej u pacjentów w wieku 80 lat i powyżej

Karolina Piotrowicz,

Alicja Klich-Rączka,

Barbara Wizner,

Marcin Czech,

Tomasz Grodzicki


The analysis of the costs of one month of ambulatory drug therapy in the group of elderly aged 80 and over following hospital discharge

Background: It is thought that at least one medication is taken by up to 60% of elderly people. What is more, in US elderly people living in the community take on average four medications, while home-care residents take averagely seven drugs a day. The above-mentioned facts, in the light of current demographic changes of the structure of population, indicate the growing cost of ambulatory drug therapy of the elderly.

Aim of the study: To analyze the costs of one month of ambulatory drug therapy in the group of elderly aged 80 and over following hospital discharge. Moreover, the relation between the number of pills and drugs taken in general, concomitant illnesses and costs of therapy were assessed.

Materials and methods: The retrospective analysis of medical documentation of 116 patients aged 80 and over was performed. The costs of therapy were calculated accordingly to the prices published in The Drug Index. Co-morbid illnesses were classified accordingly to the International Classification of Diseases (ICD-10). Analysis in the age subgroups was performed.

Results: Mean age was 85.2 ± 4.2y-rs, group consisted of 62 women and 27 men; 27 patients were excluded from further analysis. Mean number of prescribed drugs was 7.6 ± 2.9 (min.–max.: 1–16), mean number of prescribed pills was 8.8 ± 4.3 (min.–max.: 0–23). Patients in the examined group suffered from 5.8 ± 2.0 chronic diseases averagely. Mean cost of one month of ambulatory drug therapy was 135.9 ± 95.7 PLN (min.–max.: 1,96–625,9 PLN). Significant relations between the costs of ambulatory drug therapy and the number of chronic diseases (r = 0.51, p < 0.0001) as well as the number of pills (r = 0.68, p < 0.001) and drugs (r = 0.74, p < 0.001) were observed. The differences in the subgroups were observed.

Conclusions: The high co-morbidity observed in the elderly results in the need for taking a great number of drugs and consequently causes high costs of ambulatory drug therapy. When planning ambulatory treatment, it is important to analyze the patients’ and their families’ financial situation, and when necessary provide economical support.

Słowa kluczowe: koszty leczenia, wielochorobowość, starość, starzenie się
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