Cost attributable to nosocomial bacteremia. Analysis according to microorganism and antimicrobial sensitivity in a University Hospital in Barcelona.

AIM: To calculate the incremental cost of nosocomial bacteremia caused by the most common organisms, classified by their antimicrobial susceptibility. METHODS: We selected patients who developed nosocomial bacteremia caused by Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, or Pseudo...

Full description

Bibliographic Details
Authors: Riu Camps, Marta, Chiarello, Pietro, Terradas Robledo, Roser, Sala i Serra, Maria, Garcia-Alzorriz, Enric, Castells, Xavier, Grau Cerrato, Santiago, Cots Reguant, Francesc
Format: article
Status:Published version
Publication Date:2016
Country:España
Institution:Universitat Pompeu Fabra
Repository:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/26946
Online Access:http://hdl.handle.net/10230/26946
http://dx.doi.org/10.1371/journal.pone.0153076
Access Level:Open access
Keyword:Infeccions nosocomials -- Epidemiologia
id ES_fac3b5f6f603cf06fb12d8f25657a2ec
oai_identifier_str oai:repositori.upf.edu:10230/26946
network_acronym_str ES
network_name_str España
repository_id_str
spelling Cost attributable to nosocomial bacteremia. Analysis according to microorganism and antimicrobial sensitivity in a University Hospital in Barcelona.Riu Camps, MartaChiarello, PietroTerradas Robledo, RoserSala i Serra, MariaGarcia-Alzorriz, EnricCastells, XavierGrau Cerrato, SantiagoCots Reguant, FrancescInfeccions nosocomials -- EpidemiologiaAIM: To calculate the incremental cost of nosocomial bacteremia caused by the most common organisms, classified by their antimicrobial susceptibility. METHODS: We selected patients who developed nosocomial bacteremia caused by Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, or Pseudomonas aeruginosa. These microorganisms were analyzed because of their high prevalence and they frequently present multidrug resistance. A control group consisted of patients classified within the same all-patient refined-diagnosis related group without bacteremia. Our hospital has an established cost accounting system (full-costing) that uses activity-based criteria to analyze cost distribution. A logistic regression model was fitted to estimate the probability of developing bacteremia for each admission (propensity score) and was used for propensity score matching adjustment. Subsequently, the propensity score was included in an econometric model to adjust the incremental cost of patients who developed bacteremia, as well as differences in this cost, depending on whether the microorganism was multidrug-resistant or multidrug-sensitive. RESULTS: A total of 571 admissions with bacteremia matched the inclusion criteria and 82,022 were included in the control group. The mean cost was € 25,891 for admissions with bacteremia and € 6,750 for those without bacteremia. The mean incremental cost was estimated at € 15,151 (CI, € 11,570 to € 18,733). Multidrug-resistant P. aeruginosa bacteremia had the highest mean incremental cost, € 44,709 (CI, € 34,559 to € 54,859). Antimicrobial-susceptible E. coli nosocomial bacteremia had the lowest mean incremental cost, € 10,481 (CI, € 8,752 to € 12,210). Despite their lower cost, episodes of antimicrobial-susceptible E. coli nosocomial bacteremia had a major impact due to their high frequency. CONCLUSIONS: Adjustment of hospital cost according to the organism causing bacteremia and antibiotic sensitivity could improve prevention strategies and allow their prioritization according to their overall impact and costs. Infection reduction is a strategy to reduce resistance.Public Library of Science201620162016info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/26946http://dx.doi.org/10.1371/journal.pone.0153076reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésPLoS One. 2016 Apr 7;11(4):e0153076© 2016 Riu et al. This is an open accessarticle distributed under the terms of the http://creativecommons.org/licenses/by/4.0/, which permitsunrestricted use, distribution, and reproduction in anymedium, provided the original author and source arecreditedhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/269462026-06-12T07:21:37Z
dc.title.none.fl_str_mv Cost attributable to nosocomial bacteremia. Analysis according to microorganism and antimicrobial sensitivity in a University Hospital in Barcelona.
title Cost attributable to nosocomial bacteremia. Analysis according to microorganism and antimicrobial sensitivity in a University Hospital in Barcelona.
spellingShingle Cost attributable to nosocomial bacteremia. Analysis according to microorganism and antimicrobial sensitivity in a University Hospital in Barcelona.
Riu Camps, Marta
Infeccions nosocomials -- Epidemiologia
title_short Cost attributable to nosocomial bacteremia. Analysis according to microorganism and antimicrobial sensitivity in a University Hospital in Barcelona.
title_full Cost attributable to nosocomial bacteremia. Analysis according to microorganism and antimicrobial sensitivity in a University Hospital in Barcelona.
title_fullStr Cost attributable to nosocomial bacteremia. Analysis according to microorganism and antimicrobial sensitivity in a University Hospital in Barcelona.
title_full_unstemmed Cost attributable to nosocomial bacteremia. Analysis according to microorganism and antimicrobial sensitivity in a University Hospital in Barcelona.
title_sort Cost attributable to nosocomial bacteremia. Analysis according to microorganism and antimicrobial sensitivity in a University Hospital in Barcelona.
dc.creator.none.fl_str_mv Riu Camps, Marta
Chiarello, Pietro
Terradas Robledo, Roser
Sala i Serra, Maria
Garcia-Alzorriz, Enric
Castells, Xavier
Grau Cerrato, Santiago
Cots Reguant, Francesc
author Riu Camps, Marta
author_facet Riu Camps, Marta
Chiarello, Pietro
Terradas Robledo, Roser
Sala i Serra, Maria
Garcia-Alzorriz, Enric
Castells, Xavier
Grau Cerrato, Santiago
Cots Reguant, Francesc
author_role author
author2 Chiarello, Pietro
Terradas Robledo, Roser
Sala i Serra, Maria
Garcia-Alzorriz, Enric
Castells, Xavier
Grau Cerrato, Santiago
Cots Reguant, Francesc
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Infeccions nosocomials -- Epidemiologia
topic Infeccions nosocomials -- Epidemiologia
description AIM: To calculate the incremental cost of nosocomial bacteremia caused by the most common organisms, classified by their antimicrobial susceptibility. METHODS: We selected patients who developed nosocomial bacteremia caused by Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, or Pseudomonas aeruginosa. These microorganisms were analyzed because of their high prevalence and they frequently present multidrug resistance. A control group consisted of patients classified within the same all-patient refined-diagnosis related group without bacteremia. Our hospital has an established cost accounting system (full-costing) that uses activity-based criteria to analyze cost distribution. A logistic regression model was fitted to estimate the probability of developing bacteremia for each admission (propensity score) and was used for propensity score matching adjustment. Subsequently, the propensity score was included in an econometric model to adjust the incremental cost of patients who developed bacteremia, as well as differences in this cost, depending on whether the microorganism was multidrug-resistant or multidrug-sensitive. RESULTS: A total of 571 admissions with bacteremia matched the inclusion criteria and 82,022 were included in the control group. The mean cost was € 25,891 for admissions with bacteremia and € 6,750 for those without bacteremia. The mean incremental cost was estimated at € 15,151 (CI, € 11,570 to € 18,733). Multidrug-resistant P. aeruginosa bacteremia had the highest mean incremental cost, € 44,709 (CI, € 34,559 to € 54,859). Antimicrobial-susceptible E. coli nosocomial bacteremia had the lowest mean incremental cost, € 10,481 (CI, € 8,752 to € 12,210). Despite their lower cost, episodes of antimicrobial-susceptible E. coli nosocomial bacteremia had a major impact due to their high frequency. CONCLUSIONS: Adjustment of hospital cost according to the organism causing bacteremia and antibiotic sensitivity could improve prevention strategies and allow their prioritization according to their overall impact and costs. Infection reduction is a strategy to reduce resistance.
publishDate 2016
dc.date.none.fl_str_mv 2016
2016
2016
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/26946
http://dx.doi.org/10.1371/journal.pone.0153076
url http://hdl.handle.net/10230/26946
http://dx.doi.org/10.1371/journal.pone.0153076
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv PLoS One. 2016 Apr 7;11(4):e0153076
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Public Library of Science
publisher.none.fl_str_mv Public Library of Science
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869425241310101504
score 15.812429

Similar Items