Healthcare cost and utilization analysis of a nationwide digital primary care intervention for type 2 diabetes in Türkiye

Abstract Background Diabetes is a priority health challenge both globally and in Türkiye, due to its clinical burden and economic consequences. The aim of this study is to evaluate the performance of a national Disease Management Platform (HYP), a digital clinical decision-support system regarding healthcare utilization and costs among patients with type 2 diabetes. Methods A retrospective cohort analysis was conducted using national real-world data from the e-Nabiz database. A Difference-in-Differences (DiD) framework and matched sampling were utilized to compare 19,995 patients managed through HYP in 2022 with . Multivariable regression models served as the primary analytical tool to estimate effect sizes for healthcare expenditures and service utilization. Results Multivariable regression models demonstrated that the HYP intervention was associated with a 50% increase in primary care follow-up engagement and a significant reduction in hospital admissions compared to the control group. The HYP group showed a significant decline in average annual per capita costs (average reduction of 662 TRY [≈ 40 USD]; p < 0.001) and reduced pharmaceutical use. If replicated at national scale, these per-patient differences would correspond to an illustrative saving of approximately 5.97 billion TRY (≈ 360 million USD) annually. Conclusions This study suggests 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 is associated with lower per-patient expenditure and provides a scalable model for national digital health priorities in middle-income settings.