RESUMO
OBJECTIVE: The aim of this study was to identify, from a health care perspective, the cost of treatment for chronic lymphocytic leukemia in specialized hospitals in Ukraine. METHODS: Cost analysis was performed by using retrospective data between 2006 and 2010 from patient-file databases of two specialized hospitals (145 patients). Uncertainty was assessed by using bootstrapping and multivariate sensitivity analyses. Linear regression analysis was used to analyze whether patients' characteristics are related to health care costs. In addition, one-way analysis of variance (Welch test) and paired-sample t test were conducted to compare mean costs of treatment between the two hospitals and mean expenses for drugs and in-hospital stay. RESULTS: The average annual cost for a patient's drug treatment is 2047 EUR. The cost of hospitalization was significantly lower (t = 5.026; significance two-tailed = 0.000) and equal to 541 EUR per person, resulting in total expenditures of 2589 EUR. Mean total costs in the bootstrap analysis were equal to 2584 EUR (median 2576 EUR, 97.5th percentile 3223 EUR; 2.5th percentile 1987 EUR). The regression analysis did not reveal a relation between patients' characteristics and health care costs, although hospital choice was an influential parameter (ß = -0.260; significance = 0.002). Significant difference in mean costs of two analyzed hospitals was also confirmed by one-way analysis of variance (Welch statistics 19.222, P = 0.000). CONCLUSIONS: Drug treatment comprises the largest portion of total costs, but differences between hospitals exist. Because many patients in Ukraine pay out of pocket for in-hospital drugs, these costs are a high economic burden for patients with chronic lymphocytic leukemia.
RESUMO
This study evaluates the impact of hypoglycemia on the lives of Ukrainian patients with type 2 diabetes mellitus. The secondary objective was to explore patient-physician relationships and the attitudes of patients towards various informational resources on diabetes management. Three focus groups with 26 patients were conducted. Qualitative information was evaluated using content analysis. The results show that patients with type 2 diabetes mellitus in Ukraine are adapting to potential attacks of hypoglycemia; however, they still experience periodic manifestations of hypoglycemia that significantly affect their psychological well-being. This result is similar to observations made in other countries. Ukrainian patients >40 years old mainly receive information on disease management from endocrinologists, and rarely use internet resources on diabetes management. Information provision was especially important at the early stage of the disease, when patients lack information on hypoglycemia manifestations and could therefore fail to identify and manage it properly.