Nationwide digital primary care platform linked to lower diabetes costs in Türkiye

A nationwide digital disease-management platform in Türkiye was associated with lower healthcare costs and reduced hospital admissions among patients with type 2 diabetes, according to a retrospective cohort study published in BMC Health Services Research. The platform, known as HYP, is a national Disease Management Platform that functions as a digital clinical decision-support system, and the study evaluated its performance in terms of healthcare utilization and costs.

Using a Difference-in-Differences framework combined with matched sampling, they compared 19,995 patients managed through HYP in 2022 with a matched control group. Multivariable regression models served as the primary analytical tool for estimating effect sizes on healthcare expenditures and service utilization.

The regression analysis showed that the HYP intervention was associated with a 50% increase in primary care follow-up engagement and a significant reduction in hospital admissions compared with the control group. Patients on the platform also showed reduced pharmaceutical use over the study period.

Costs moved in the same direction. The HYP group experienced a significant decline in average annual per capita costs, with an average reduction of 662 TRY, approximately 40 USD, at a statistical significance level of p < 0.001.

The study also offers an illustrative projection of what these per-patient differences would mean if replicated at national scale: approximately 5.97 billion TRY, or roughly 360 million USD, in annual savings. This is a modeled extrapolation based on the observed per-patient differences, not a measured national saving, and its realization would depend on the platform’s effects holding true across the broader national population.

The authors conclude that HYP may be an effective service delivery model for chronic diseases such as diabetes in Türkiye. By strengthening primary care coordination and optimizing service flow, the platform was associated with lower per-patient expenditure and is presented as a scalable model for national digital health priorities in middle-income settings.

Several limitations shape how these findings should be read. The analysis is retrospective and observational, so the reported associations between platform use and lower costs or fewer admissions cannot establish causation with the certainty of a randomized trial. The matched Difference-in-Differences design is intended to reduce confounding, but unmeasured differences between patients managed through HYP and those in the control group could still influence the results. The findings also apply specifically to patients with type 2 diabetes in the Turkish health system in 2022, and the authors themselves frame the national-scale saving figure as illustrative rather than demonstrated.

Diabetes is described in the study as a priority health challenge both globally and in Türkiye because of its clinical burden and economic consequences, which is what motivated the evaluation of a digital platform aimed at managing the disease at the primary care level. Within that context, the study suggests that a decision-support platform embedded in a national health data infrastructure can shift care toward primary care follow-up while being associated with lower hospital utilization and per-patient spending. The authors position the work as evidence that such platforms merit consideration in national digital health strategies, while the projected savings remain contingent on replication of the observed effects at scale.

Subject of Research: Healthcare cost and utilization outcomes of a nationwide digital primary care platform for type 2 diabetes in Türkiye

Article Title: Healthcare cost and utilization analysis of a nationwide digital primary care intervention for type 2 diabetes in Türki̇ye

Article References: Tellioğlu, H. A., Öztürk, M., & Kavuncubaşı, Ş. (2026). Healthcare cost and utilization analysis of a nationwide digital primary care intervention for type 2 diabetes in Türki̇ye. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15927-8

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15927-8

Keywords: type 2 diabetes, digital health, primary care, Türkiye, healthcare costs, hospital admissions, difference-in-differences, e-Nabiz, disease management platform, health services research, Healthcare, cost