Evaluation of reimbursements made by the social security institution for patients who died in intensive care

The aim of this study is to examine the factors affecting on Social Security Institution (SSI) Reimbursements (SSIRs) made for patients who died while receiving treatment in the 3rd level intensive care unit (ICU) of a 2nd degree state hospital in Ankara. This study designed as retrospective was carried out on the Social Security Institution Reimbursements (SSIRs) made for 453 patients who died in ICU between 1st January 2014 and 31st December 2017. It has been determined that the average age of the patients included in the study was 75.02 ± 14.28, gender ratio was 53.20% (n=241) man, average days of length of stay in ICU was 60.65 ± 72.12, and average Social Security Institution Reimbursements was ₺ 48 979.69 TL ± ₺ 2 785.67 TL. It has been determined that the most common condition was pressure injury with 60.49% (n= 274) for the patients in the study, the common infection was urinary system infection with 27.15% (n = 123), and the most common infection factor was E. Coli with 20.54% (n=92) in these infections. While 88.30% (n = 400) of the patients are breathing with mechanical ventilation, 65.56% (n = 297) are fed with PEG. The constant of the regression model, which examines the factors affecting the patients' Social Security Institution Reimbursements, was determined as 9.997 ± 0.176 in the logarithmic scale and as ₺ 21 960 TL on the normal scale. It has been seen that the reimbursement was lower in patients with poor general condition, in patients with cancer patients, in patients with cardiovascular system disease (b<0, p<0.05); on the other hand, the reimbursement was higher in patients with hypoxic ischemic brain damage, in patients with an infection, and in patients with PEG (b>0, p<0.05). 26.7% of the variability of Social Security Institution Reimbursements is explained by the relevant model. The constant of the regression model, which was established to examine the factors affecting the length of stay, was determined as 3.354 ± 0.164 on the logarithmic scale and 28.62 days on the normal scale. It was found that this shortened the average length of stay in patients with poor general condition, in patients with cancer patients, in patients with cardiovascular system disease (b <0, p <0.05); on the other hand, this prolonged the mean length of stay in patients with hypoxic ischemic brain damage, in patients with an infection, and in patients with PEG (b> 0, p <0.05). 26.5% of the variability in hospitalization period is explained by the relevant model. Factors that increase the length of stay also contribute to the increase in Social Security Institution Reimbursements. It is thought that review and re-planning the planning of ICU based on the conditions of the patients, especially the hospitals with high acute patient density, may reduce the patient density in ICU and contribute to the decrease in Social Security Institution Reimbursements.