Cost Analysis of Nosocomial Infections in a Tertiary Care Referral Hospital's Neurology Intensive Care Unit: A Case-Control Study
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Tarih
2015
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmanın amacı, üçüncü basamak bir nöroloji yoğun bakım ünitesinde hastane enfeksiyonlarına (HE) yol açan risk etkenlerinin belirlenmesi, klinik ve direkt hastane maliyetlerinin hesaplanmasıdır. Gereç ve Yöntem: Retrospektif olgu-kontrol çalışması olarak planlanmıştır. Örnek büyüklüğü grup başına en az 51 olarak hesaplanmıştır. Hastane enfeksiyon kontrol komitesinden, nöroloji yoğun bakım ünitesinde hastane enfeksiyonu tanısı alan en son 55 hastanın listesi elde edilmiştir. Bu hastalar yaş, cinsiyet, tanı açısından hastane enfeksiyonu gelişmemiş hastalar ile eşleştirilmiştir. Veriler hasta dosyaları ve muhasebe kayıtlarından alınmıştır. Bulgular: Olgu grubundaki 55 hastada toplam 79 HE saptanmıştır. Pnömoni (% 48) ve kateter ile ilgili üriner sistem enfeksiyonu (% 39) en yaygın görülen HE'dir. Acinetobacter baumannii (% 25)en sık üreyen etmen olarak saptanmıştır. HE, bilinci açık, entübe edilmemiş, kan transfüzyonu yapılmamış, trakeostomisi, üriner kateteri olmayan ya da mekanik ventilasyon bağlı olmayan hastalarda daha az görülmüştür. Ölüm oranı olgularda % 53.1 ve kontrollerde% 30.8 bulunmuştur. HE'ye ait ek maliyet 7.121,15 $ ve uzamış yatış günü hasta başına 26,9 gün olarak saptanmıştır. Sosyal Güvenlik Kurumu, geri ödeme süresi altı ayı aşmakla beraber tüm toplam fatura tutarını geri ödemiştir. Sonuç: Hastane enfeksiyonlarının sağlık ve parasal maliyetleri göz önüne alındığında, hasta güvenliği ve hastane itibarı için HE önlemek öncelenmelidir. Üçüncü basamak hastanelerinde yoğun bakım üniteleri hastane bütçesine yük getirmemekte, aksine bütçeyi dengelemek için bir fırsat sağlamaktadır.
Aim: The purpose of this study is to overview nosocomial infections (NI), to determine risk factors and to evaluate the clinical and financial impact of NI on direct hospital cost among neurology intensive care unit (NICU) patients in a tertiary-care referral hospital. Material and Methods: A retrospective case control study was performed. The sample size was calculated to be at least 51 per group. A list of the last 55 patients who acquired an infection in NICU was obtained from infection control committee. These patients were matched with uninfected patients according to age, sex, diagnosis. The data were collected from patient files, accounting records. Results: A total of 79 NI occurred in 55 cases. The most common NI were pneumonia (48%), catheter related urinary tract infection (39%). Acinetobacter baumannii (25%) is most commonly responsible for NI. NI were detected less in patients who were conscious, non- intubated, without blood transfusion, tracheostomy, urinary catheter or mechanical ventilation. The mortality ratio was 53.1% in cases and 30.8% in controls. The excess costs of NI were $7121.15 and extra length of stay was 26.9 days. Although reimbursement took longer than six months, the Social Security Institution paid back the total billing amount. Conclusion: Given the impact on monetary and health costs of NI, measures to prevent NI in the hospital are strongly recommended for patient safety and for hospital reputation. NICUs in tertiary care referral facilities do not cause financial burden; on the contrary, they provide an opportunity to balance the budget.
Aim: The purpose of this study is to overview nosocomial infections (NI), to determine risk factors and to evaluate the clinical and financial impact of NI on direct hospital cost among neurology intensive care unit (NICU) patients in a tertiary-care referral hospital. Material and Methods: A retrospective case control study was performed. The sample size was calculated to be at least 51 per group. A list of the last 55 patients who acquired an infection in NICU was obtained from infection control committee. These patients were matched with uninfected patients according to age, sex, diagnosis. The data were collected from patient files, accounting records. Results: A total of 79 NI occurred in 55 cases. The most common NI were pneumonia (48%), catheter related urinary tract infection (39%). Acinetobacter baumannii (25%) is most commonly responsible for NI. NI were detected less in patients who were conscious, non- intubated, without blood transfusion, tracheostomy, urinary catheter or mechanical ventilation. The mortality ratio was 53.1% in cases and 30.8% in controls. The excess costs of NI were $7121.15 and extra length of stay was 26.9 days. Although reimbursement took longer than six months, the Social Security Institution paid back the total billing amount. Conclusion: Given the impact on monetary and health costs of NI, measures to prevent NI in the hospital are strongly recommended for patient safety and for hospital reputation. NICUs in tertiary care referral facilities do not cause financial burden; on the contrary, they provide an opportunity to balance the budget.
Açıklama
Anahtar Kelimeler
Nörolojik Bilimler
Kaynak
Journal of Neurological Sciences (Turkish)
WoS Q Değeri
Scopus Q Değeri
Cilt
32
Sayı
3
