Incremental cost of nosocomial bacteremia according to the focus of infection and antibiotic sensitivity of the causative microorganism in a university hospital
Riu, Marta (Institut Hospital del Mar d'Investigacions Mèdiques)
Chiarello, Pietro (Institut Hospital del Mar d'Investigacions Mèdiques)
Terradas, Roser (Institut Hospital del Mar d'Investigacions Mèdiques)
Sala, Maria (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Garcia-Alzorriz, Enric (Institut Hospital del Mar d'Investigacions Mèdiques)
Castells, Xavier (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Grau, Santiago (Universitat Autònoma de Barcelona. Departament de Farmacologia, de Terapèutica i de Toxicologia)
Cots Reguant, Francesc (Institut Hospital del Mar d'Investigacions Mèdiques)

Data:	2017
Resum:	To estimate the incremental cost of nosocomial bacteremia according to the causative focus and classified by the antibiotic sensitivity of the microorganism. Patients admitted to Hospital del Mar in Barcelona from 2005 to 2012 were included. We analyzed the total hospital costs of patients with nosocomial bacteremia caused by microorganisms with a high prevalence and, often, with multidrug-resistance. A control group was defined by selecting patients without bacteremia in the same diagnosis-related group. Our hospital has a cost accounting system (full-costing) that uses activity-based criteria to estimate per-patient costs. A logistic regression was fitted to estimate the probability of developing bacteremia (propensity score) and was used for propensity-score matching adjustment. This propensity score was included in an econometric model to adjust the incremental cost of patients with bacteremia with differentiation of the causative focus and antibiotic sensitivity. The mean incremental cost was estimated at €15,526. The lowest incremental cost corresponded to bacteremia caused by multidrug-sensitive urinary infection (€6786) and the highest to primary or unknown sources of bacteremia caused by multidrug-resistant microorganisms (€29,186). This is one of the first analyses to include all episodes of bacteremia produced during hospital stays in a single study. The study included accurate information about the focus and antibiotic sensitivity of the causative organism and actual hospital costs. It provides information that could be useful to improve, establish, and prioritize prevention strategies for nosocomial infections.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Economic impact ; Focus of bacteremia ; Hospital costs ; Multidrug-resistant microorganisms ; Nosocomial bacteremia
Publicat a:	Medicine, Vol. 96 (april 2017) , ISSN 1536-5964

DOI: 10.1097/MD.0000000000006645
PMID: 28445264

6 p, 193.9 KB

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats