Oscar Sosa-Hernández1, Bernadine Matías-Téllez2, Abril Estrada-Hernández2, Monica Alethia Cureño-Díaz3, Juan Manuel Bello-López4. 1. Unidad de Vigilancia Epidemiológica Hospitalaria, Hospital Juárez de México. Electronic address: dr.oscar.sh@gmail.com. 2. Unidad de Vigilancia Epidemiológica Hospitalaria, Hospital Juárez de México. 3. Dirección de Planeación Estratégica, Hospital Juárez de México. 4. Unidad de Investigación en Microbiología y Toxicología, Hospital Juárez de México.
Abstract
BACKGROUND: Ventilator-associated pneumonia (VAP) is defined as pneumonia that occurs after 48 hours of endotracheal intubation and initiation of mechanical ventilation. The aim of this work was to use a micro-costing method to calculate the costs generated in 2017 for the care of patients with VAP at the Hospital Juárez de México. METHODS: We performed a cross-sectional, retrospective, analytical, and observational study of the databases of the registry of health care-associated infections (HAIs) in 2017, in addition to a micro-costing study. RESULTS: We studied 48 VAP cases in an adult intensive care unit (AICU). In this period, 1668 ventilator days were identified, with an incidence rate of 28.8 per 1000 days. All cases were caused by multidrug-resistant (MDR) bacteria and the costs of their care exceeded the average costs for the use of antimicrobials. By calculating the profit on return as an association measure, we found that VAP caused by MDR bacteria confers 9 times the risk of increasing the costs of care above the expected average. CONCLUSIONS: The cost for a case of VAP in the AICU is high and has an impact on the institutional budget. Control measures to prevent the spread of bacteria, particularly MDR bacteria, must be put into place in order to avoid increases in hospital stay costs and mortality.
BACKGROUND: Ventilator-associated pneumonia (VAP) is defined as pneumonia that occurs after 48 hours of endotracheal intubation and initiation of mechanical ventilation. The aim of this work was to use a micro-costing method to calculate the costs generated in 2017 for the care of patients with VAP at the Hospital Juárez de México. METHODS: We performed a cross-sectional, retrospective, analytical, and observational study of the databases of the registry of health care-associated infections (HAIs) in 2017, in addition to a micro-costing study. RESULTS: We studied 48 VAP cases in an adult intensive care unit (AICU). In this period, 1668 ventilator days were identified, with an incidence rate of 28.8 per 1000 days. All cases were caused by multidrug-resistant (MDR) bacteria and the costs of their care exceeded the average costs for the use of antimicrobials. By calculating the profit on return as an association measure, we found that VAP caused by MDR bacteria confers 9 times the risk of increasing the costs of care above the expected average. CONCLUSIONS: The cost for a case of VAP in the AICU is high and has an impact on the institutional budget. Control measures to prevent the spread of bacteria, particularly MDR bacteria, must be put into place in order to avoid increases in hospital stay costs and mortality.
Authors: Gabriela Ibáñez-Cervantes; Juan Carlos Bravata-Alcántara; Alan Steve Nájera-Cortés; Sergio Meneses-Cruz; Laura Delgado-Balbuena; Clemente Cruz-Cruz; Emilio Mariano Durán-Manuel; Monica Alethia Cureño-Díaz; Erika Gómez-Zamora; Sonia Chávez-Ocaña; Oscar Sosa-Hernández; Antonio Aguilar-Rojas; Juan Manuel Bello-López Journal: Am J Infect Control Date: 2020-07-06 Impact factor: 2.918