David de la Rosa Carrillo1, Annie Navarro Rolon2, Rosa Maria Girón Moreno3, Beatriz Montull Veiga4, Casilda Olveira Fuster5, Alicia Padilla Galo6, Concepción Prados Sánchez7, Esther Quintana Gallego8, Oriol Sibila Vidal9, Nuria Celorrio Jiménez10, Antonio Ruiz Peña11, Antoni Torres Martí12, Maria Jesús Avilés Inglés13, Marina Blanco Aparicio14, Marta García-Clemente15, Rafael Golpe Gómez16, Ainhoa Gómez Bonilla17, Cristina Gómez González18, Maria Victoria Leal Arranz19, Patricia Mínguez Clemente20, Belén López Muñiz21, Luis Máiz Carro22, Ana Pando Sandoval15, Juan Luis Rodríguez Hermosa23, Ane Uranga Echeverria24, Ana Núñez Ares25, Lorena López Roldán26, Carmen Abellán Martínez13, Abel Jesús Martínez García25, Francisco Javier Michel de la Rosa27, Raúl Godoy Mayoral28, Miguel Ángel Martínez-García4. 1. Pneumology Service, Hospital Plató, Barcelona, Spain. 2. Pneumology Service, Hospital Mutua de Terrassa, Terrassa, Spain. 3. Pneumology Service, Hospital de la Princesa, Madrid, Spain. 4. Pneumology Service, Hospital Universitario y Politécnico de La Fe, Valencia, Spain. 5. Pneumology Service, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga/Universidad de Málaga, Málaga, Spain. 6. Pneumology Service, Hospital Costa del Sol, Marbella, Spain. 7. Pneumology Service, Hospital Universitario La Paz-IS Carlos III, Madrid, Spain. 8. Pneumology Service, Hospital Universitario Virgen del Rocío, Sevilla, Spain. 9. Pneumology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 10. Pneumology Service, Hospital de Viladecans, Viladecans, Spain. 11. Pneumology Service, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain. 12. Respiratory Institute, Hospital Clinic i Provincial, Barcelona, Spain. 13. Pneumology Service, Hospital General Universitario Reina Sofía, Murcia, Spain. 14. Pneumology Service, Complexo Hospitalario Universitario A Coruña, Coruña, Spain. 15. Pneumology Service, Hospital Universitario Central de Asturias, Oviedo, Spain. 16. Pneumology Service, Hospital Universitario Lucus Augustí, Lugo, Spain. 17. Pneumology Service, Hospital de Cruces, Baracaldo, Spain. 18. Pneumology Service, Hospital General de la Defensa, Zaragoza, Spain. 19. Pneumology Service, Hospital Basurto, Bilbao, Spain. 20. Pneumology Service, Hospital Universitario Puerta de Hierro, Majadahonda, Spain. 21. Pneumology Service, Hospital Universitario Infanta Leonor, Madrid, Spain. 22. Pneumology Service, Hospital Universitario Ramón y Cajal, Madrid, Spain. 23. Pneumology Service, Hospital Clínico San Carlos, Madrid, Spain. 24. Pneumology Service, Hospital de Galdakao, Galdakao, Spain. 25. Pneumology Service, Hospital General Universitario de Albacete, Albacete, Spain. 26. Pneumology Service, Hospital de Santa Marina, Bilbao, Spain. 27. Pneumology Service, Hospital Universitario Donostia, San Sebastian, Spain. 28. Pneumology Service, Hospital Universitario Nuestra Señora del Perpetuo Socorro, Albacete, Spain.
Abstract
BACKGROUND: Knowing the cost of hospitalizations for exacerbation in bronchiectasis patients is essential to perform cost-effectiveness studies of treatments that aim to reduce exacerbations in these patients. OBJECTIVES: To find out the mean cost of hospitalizations due to exacerbations in bronchiectasis patients, and to identify factors associated with higher costs. METHODS: Prospective, observational, multicenter study in adult bronchiectasis patients hospitalized due to exacerbation. All expenses from the patients' arrival at hospital to their discharge were calculated: diagnostic tests, treatments, transferals, home hospitalization, admission to convalescence centers, and hospitals' structural costs for each patient (each hospital's tariff for emergencies and 70% of the price of a bed for each day in a hospital ward). RESULTS: A total of 222 patients (52.7% men, mean age 71.8 years) admitted to 29 hospitals were included. Adding together all the expenses, the mean cost of the hospitalization was EUR 5,284.7, most of which correspond to the hospital ward (86.9%), and particularly to the hospitals' structural costs. The adjusted multivariate analysis showed that chronic bronchial infection by Pseudomonas aeruginosa, days spent in the hospital, and completing the treatment with home hospitalization were factors independently associated with a higher overall cost of the hospitalization. CONCLUSIONS: The mean cost of a hospitalization due to bronchiectasis exacerbation obtained from the individual data of each episode is higher than the cost per process calculated by the health authorities. The most determining factor of a higher cost is chronic bronchial infection due to P. aeruginosa, which leads to a longer hospital stay and the use of home hospitalization.
BACKGROUND: Knowing the cost of hospitalizations for exacerbation in bronchiectasispatients is essential to perform cost-effectiveness studies of treatments that aim to reduce exacerbations in these patients. OBJECTIVES: To find out the mean cost of hospitalizations due to exacerbations in bronchiectasispatients, and to identify factors associated with higher costs. METHODS: Prospective, observational, multicenter study in adult bronchiectasispatients hospitalized due to exacerbation. All expenses from the patients' arrival at hospital to their discharge were calculated: diagnostic tests, treatments, transferals, home hospitalization, admission to convalescence centers, and hospitals' structural costs for each patient (each hospital's tariff for emergencies and 70% of the price of a bed for each day in a hospital ward). RESULTS: A total of 222 patients (52.7% men, mean age 71.8 years) admitted to 29 hospitals were included. Adding together all the expenses, the mean cost of the hospitalization was EUR 5,284.7, most of which correspond to the hospital ward (86.9%), and particularly to the hospitals' structural costs. The adjusted multivariate analysis showed that chronic bronchial infection by Pseudomonas aeruginosa, days spent in the hospital, and completing the treatment with home hospitalization were factors independently associated with a higher overall cost of the hospitalization. CONCLUSIONS: The mean cost of a hospitalization due to bronchiectasis exacerbation obtained from the individual data of each episode is higher than the cost per process calculated by the health authorities. The most determining factor of a higher cost is chronic bronchial infection due to P. aeruginosa, which leads to a longer hospital stay and the use of home hospitalization.
Authors: Mônica Corso Pereira; Rodrigo Abensur Athanazio; Paulo de Tarso Roth Dalcin; Mara Rúbia Fernandes de Figueiredo; Mauro Gomes; Clarice Guimarães de Freitas; Fernando Ludgren; Ilma Aparecida Paschoal; Samia Zahi Rached; Rosemeri Maurici Journal: J Bras Pneumol Date: 2019-08-12 Impact factor: 2.624