[Estimating the costs associated with nosocomial urinary tract infection. A case-control study]. / Estimación de los costes asociados a la infección urinaria nosocomial. Un estudio de casos y controles.

BACKGROUND: Nosocomial infection (NI) is associated with increased resource use. The current study addressed the cost excess attributable to nosocomial urinary tract infection (NUTI). METHODS: Case-control study conducted in a cohort population. For matching, the Diagnostic Related Group (DRG) to which the episode of case patient was ascribed was used. Then, a further search was conducted in the hospital discharge database with the following parameters: DRG, gender, age, admission date, department, comparison of length of stays, main diagnosis, co-morbidities, number of secondary diagnoses and procedures. Matching was achieved for 64 episodes (71%), and upon them an estimation of costs was performed. RESULTS: The mean length of stay for cases were 15.3 (median: 12) and 12.3 (median: 11) days for cases and controls, respectively (p = 0.0001). The excess of length of stay attributable to NUTI was 3 days (95% CI 1.6-4.7), longer for patients admitted to Medical Departments (5.3 days) than for patients admitted to Surgical Departments (2 days) (p = 0,03). The use of diagnostic resources was significantly higher for bacteriological testing only. The use of antibiotics and fluid therapy was higher among infected patients. Out of the total excess of the estimated costs per episode, 132,047 ptas, 93% corresponded to the increase in hospital stay. Ten patients (15.6%) were responsible for 68% of the total of extra-costs. In 17 occasions (26.6%), the control patient used more resources than the infected patient. CONCLUSIONS: Nosocomial urinary tract infection is associated with a resource use directly related to its presence. For the most part, it is related to the prolongation of hospital stay.

Estimación de los costes asociados a la infección urinaria nosocomial. Un estudio de casos y controles / Estimating the costs associated with nosocomial urinary tract infection. A case-control study

Fundamento. La infección nosocomial (IN) se acompaña de un incremento en el consumo de recursos. En el presente estudio se estima el exceso de costes atribuible a la infección urinaria nosocomial (IUN).Métodos. Se realizó un estudio de casos y controles anidado en un estudio de cohortes. Para el apareamiento se partió del Grupo Relacionado con el Diagnóstico (GRD) al que se adscribió el episodio del paciente caso, con una búsqueda ulterior en la base de datos de altas hospitalarias utilizando las siguientes variables: GRD, sexo, edad, fecha de ingreso, servicio, comparación de estancias, diagnóstico principal, comorbilidad, número de diagnósticos secundarios y procedimientos. Se logró el apareamiento en 64 episodios (71 por ciento), sobre los que se realizó la estimación de costes. Resultados. La estancia media fue para los casos de 15,3 días (mediana: 12) y para los controles de 12,3 días (mediana: 11); p = 0,0001. El exceso de estancia atribuible a la IUN fue de 3 días (IC 95 por ciento: 1,6-4,7), mayor para los pacientes ingresados en los servicios médicos, 5,3 días, que en aquellos que sufrieron intervenciones quirúrgicas, 2 días; p = 0,03. El consumo de recursos diagnósticos fue significativamante más elevado únicamente en pruebas bacteriológicas. El consumo de antibióticos y fluidoterapia fue mayor en los pacientes infectados. Del exceso total del coste estimado por episodio, 132.048 pesetas, el 93 por ciento corresponde al incremento de estancias. Diez pacientes (15,6 por ciento) fueron responsables del 68 por ciento del total de costes extras. En 17 ocasiones (26,6 por ciento) el paciente control consumió más recursos que el paciente infectado. Conclusiones. La infección urinaria nosocomial se acompaña de un consumo de recursos directamente relacionado con su existencia. En su mayor parte está relacionado con la prolongación de la estancia hospitalaria (AU)

[Study of costs associated with catheter-related bacteremia]. / Estudio de los costes asociados a la bacteriemia relacionada con el catéter.

BACKGROUND: Nosocomial infection (NI) is associated with an increase in resource consumption. The estimation of extra costs attributable to NI in a group of patients with catheter-related bacteremia (CRB) was the objective of the present study. METHODS: A matched case-control, study was conducted in a cohort population. Individual matching was accomplished departing from the diagnosis related group (DRG) to which the case patient episode was ascribed and later searching in the hospital discharge data base using the following parameters: DRG, sex, age, admission date, department, comparison of hospital stays, main diagnosis, co-morbidity, number of secondary diagnoses and procedures. Matching was obtained for 22 cases (68.7%), upon which the cost estimations were performed. RESULTS: The mean hospital stay length for cases was 26.5 days (median: 24.5) and for controls 14.5 days (median: 13.5), p = 0.0002. The excess stay attributable to CRB was 11.5 days. The use of diagnostic resources was significantly higher for bacteriological tests and complete blood counts. The consumption of antibiotics and fluid therapy was higher in infected patients. Eighty-nine percent of 536,736 pesetas, the total excess of the estimated cost per episode, corresponded to the increase in hospital stay length. Seven patients (32%) were responsible for 64% of the total of extra costs. CONCLUSIONS: The method employed proved useful for estimating the costs associated with NI. The prolongation of hospital stay is responsible for most of the associated cost.