• Medicine · Apr 2017

    Observational Study

    Incremental cost of nosocomial bacteremia according to the focus of infection and antibiotic sensitivity of the causative microorganism in a university hospital.

    • Marta Riu, Pietro Chiarello, Roser Terradas, Maria Sala, Enric Garcia-Alzorriz, Xavier Castells, Santiago Grau, and Francesc Cots.
    • Management Control Department, Hospital del Mar IMIM (Hospital del Mar Medical Research Institute) Doctoral Program in Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona (UAB) School of Nursing Department of Epidemiology and Evaluation, Hospital del Mar REDISSEC (Red de Investigación en Servicios Sanitarios en enfermedades crónicas) Universitat Autònoma de Barcelona (UAB) Department of Pharmacy, Hospital del Mar, Barcelona, Spain.
    • Medicine (Baltimore). 2017 Apr 1; 96 (17): e6645e6645.

    AbstractTo 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 &OV0556;15,526. The lowest incremental cost corresponded to bacteremia caused by multidrug-sensitive urinary infection (&OV0556;6786) and the highest to primary or unknown sources of bacteremia caused by multidrug-resistant microorganisms (&OV0556;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.

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