Factors predicting the hospital episode costs of emergency medical admissions

Lahiff, Conor; Cournane, Seán; Creagh, Donnacha; Fitzgerald, Brian; Conway, Richard; Byrne, Declan; Silke, Bernard

doi:10.1016/j.ejim.2014.06.004

Cited by 7 publications

(7 citation statements)

References 24 publications

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“…Illustrating the European reality, a study performed in Ireland in 2014 found a relation between sepsis and factors that predict high hospital costs for patients admitted to the emergency room of secondary level hospitals, with an average of € 3,668.30 (R$ 6,045.50 and US$ 2,770.09) (12) . In France, the study identified 1698 patients with previous sepsis in the hospital admission unit and ICU, showing the average cost of severe sepsis of US$ 22,800.00 (R$ 51,049.20) (13) .…”

Section: Discussionmentioning

confidence: 99%

“…Pneumonia and urinary tract infection were the main infectious focus of sepsis, and the pulmonary focus showed greater impact on costs (R$ 2,908,378.00, US$ 1,298.962.93), compared with the urinary focus (R$ 723,328.00, US$ 323,058.51). Both pneumonia (16) and urinary tract infection (12) are infectious foci commonly related to the evolution to sepsis. A prospective cohort study involving 14,364 patients hospitalized in international ICUs showed that among admitted septic patients, the predominant infectious foci were related to the respiratory, digestive and urinary tract.…”

Section: Discussionmentioning

confidence: 99%

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Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization

Barreto

Dellaroza

Kerbauy

et al. 2016

Rev. esc. enferm. USP

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Objective: To estimate the cost of hospitalization of patients with severe sepsis or septic shock admitted or diagnosed in the Urgent and Emergency sector at a university hospital and followed until the clinical outcome. Method: An epidemiological, prospective, observational study conducted in a public hospital in southern Brazil for the period of one year (August 2013 to August 2014). Sepsis notification forms, medical records and data of the cost sector were used for the collection of clinical and epidemiological data. Results: The sample comprised 95 patients, resulting in a total high cost of hospitalization (R$ 3,692,421.00), and an average of R$ 38,867.60 per patient. Over half of the total value of the treatment of sepsis (R$ 2,215,773.50) was assigned to patients who progressed to death (59.0%). The higher costs were related to discharge, diagnosis of severe sepsis, the pulmonary focus of infection and the age group of up to 59 years. Conclusion: The high cost of the treatment of sepsis justifies investments in training actions and institution of protocols that can direct preventive actions, and optimize diagnosis and treatment in infected and septic patients. Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization Sepse em um hospital universitário: estudo prospectivo para análise de custo da hospitalização de pacientes Sepsis en un hospital universitario: estudio prospectivo para análisis de costo de la hospitalización de pacientes

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization

Barreto

Dellaroza

Kerbauy

et al. 2016

Rev. esc. enferm. USP

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“…In addition to the factors identified through literature review, 22 other important factors were added by experts as the determinants of HCR, which were not pointed out in previous studies. In the present study, Menke (1997), Shen and Melnick (2004) The number of outpatient visits 4 4 Carr and Feldstein (1967), Hay (2003), Menke (1997), Shen and Melnick (2004) The number of intensive care unit discharges 2 2 Menke (1997), Narine et al (1996) The number of outpatient surgeries 2008), Lahiff et al (2014), Seshamani and Gray (2004) Income (whether at the family level or national/regional level) 6 3 Hay (2003), Hung and Chang (2008), Shen and Melnick (2004) Family size at hospital society (2003), Menke (1997), Shen and Melnick (2004) Note(s): *These variables were specifically added by the experts and they were not identified in the literature review. F LR =Frequency of citation by the studies in the literature review, N SIG = Number of papers that reported a statistically significant relationship.…”

Section: Discussionmentioning

confidence: 65%

Factors affecting hospital costs and revenue: integrating expert opinions and literature review

Zalvand

Mohammadian

Amiri

2021

IJHG

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PurposeThere is not enough comprehensive evidence on factors affecting hospital costs and revenue (HCR). The main objective of the current study is to identify and classify factors affecting HCR integrating experts' opinions and literature review.Design/methodology/approachFirst, a restricted literature review is conducted to identify the factors affecting HCR. In the second step, the targeted semi-structured interviews are conducted with 15 experts to identify, validate and classify the latent factors.FindingsIn addition to the factors identified through the literature review, 22 new important factors were added by the experts as the determinants of HCR, which were not pointed out in previous studies. The final model presented for the factors affecting HCR contains seven main groups, 22 subgroups and 70 variables.Originality/valueFactors affecting HCR will provide valuable contributions for hospital budgeting, and financial and strategic planning, and they will offer an effective horizon for future research on cost-cutting strategies.

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“…Tanto a pneumonia quanto a infecção do trato urinário são comumente focos infecciosos relacionados à evolução para sepse. Estudo de coorte prospectivo, envolvendo 14.364 pacientes internados em unidades de terapia intensiva mostrou que dentre os pacientes sépticos admitidos os focos infecciosos predominantes foram relacionados ao trato respiratório, digestivo e urinário (15)(16)(17) . Com relação aos casos de sepse que Quanto à positividade de culturas, encontramos, em nossa amostra, taxas comparáveis a outras séries, mas inferiores a ensaios clínicos (18) .…”

Section: Discussionunclassified

Avaliação da aderência ao protocolo de tratamento de sepse em um hospital universitário brasileiro / Assessment of adherence to the sepsis treatment protocol at a Brazilian University Hospital

Santana

Berezin

Arnoni

et al. 2020

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

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Introdução: A sepse é um problema de saúde pública e é uma das principais causas de morte nos hospitais. Objetivos deste estudo foi classificar e descrever o perfil dos pacientes e adesão da equipe de saúde ao protocolo institucional correlacionando o impacto na taxa de letalidade por sepse e choque séptico. Métodos: Foi realizado um estudo retrospectivo dos casos de sepse e choque séptico no Pronto Socorro Central da Santa Casa de Misericórdia de São Paulo, Brasil, de 2013 a 2016. Foram analisadas as variáveis: idade, sexo, origem, fatores de risco, apresentação clínica, foco infeccioso, achados microbiológicos, tempo de internação, tipo de infecção, adesão ao protocolo institucional, exames laboratoriais, culturas, administração de antimicrobiano empírico e desfecho. Resultados: Foram incluídos um total de 434 pacientes com sepse. O predomínio foi do gênero masculino (57,6%), com predomínio de infecções comunitárias (91,6%) com idade média de 57 anos, com tempo médio de permanecia hospitalar de 15 dias e o tempo médio para o desfecho óbito foi 13 dias. Quanto ao foco primário da infecção dos pacientes incluídos no protocolo 73,2% eram casos de sepse 26,8% de choque séptico. Os principais focos foram de origem pulmonar (60,4%). A Escherichia coli foi o agente infeccioso mais prevalente (24,3%) dos casos seguido por Staphylococcus aureus (18,7%), Klebsiella spp (13,9%) e Pseudomonas spp (13,1%). O número de notificações e a aderência aos pacotes da sepse foram significantes. Houve uma redução na taxa de letalidade de 37% nos últimos três anos. Conclusões: O protocolo institucional mostrou se eficaz, otimizando as ações praticas e melhoria da qualidade, como a detecção precoce e tratamento em tempo hábil dos pacientes com sepse e o impacto nas intervenções. O processo de desenvolvimento e adesão ao protocolo foi associado ao aumento das notificações de casos e ao declínio da taxa de letalidade por sepse após a adoção das ferramentas do protocolo.Palavras chave: Sepse, Protocolos, MortalidadeABSTRACT Background: Sepsis is a public health problem and is one of the leading causes of death in hospitals. The objective of this study was to classify and describe the profile of the patients and adherence of the health team to the institutional protocol correlating the impact on the rate of lethality due to sepsis and septic shock. Methods: A retrospective study of sepsis and septic shock in the Central Emergency Room of Santa Casa de Misericórdia, São Paulo, Brazil, was carried out from 2013 to 2016. The following variables were analyzed: age, gender, origin, risk factors, presentation clinical, infectious outbreak, microbiological findings, hospitalization time, type of infection, adherence to the institutional protocol, laboratory exams, cultures, empiric antimicrobial administration and outcome. Results: A total of 434 patients with sepsis were included. The predominance was male (57.6%), with a predominance of community- -based infections (91.6%), with a mean age of 57 years, with an average length of hospital stay of 15 days, and the mean time to death was 13 days. As for the primary focus of infection of the patients included in the protocol 73.2% were cases of sepsis 26.8% of septic shock. The main foci were of pulmonary origin (60.4%). Escherichia coli was the most prevalent infectious agent (24.3%) followed by Staphylococcus aureus (18.7%), Klebsiella spp (13.9%) and Pseudomonas spp (13.1%). The number of reports and adherence to sepsis packages were significant. There has been a reduction in the lethality rate of 37% in the last three years. Conclusions: The institutional protocol proved 2 of 6 Santana SP, Berezin EN, Arnon MV, Massaia IDFS, Sprovieiri SRS. Avaliação da aderência ao protocolo de tratamento de sepse em um hospital universitário brasileiro. Arq Med Hosp Fac Cienc Med Santa Casa São Paulo. 2020; 65:e43. to be effective, optimizing practical actions and improving quality, such as the early detection and timely treatment of sepsis patients and the impact on interventions. The process of protocol development and adherence was associated with an increase in case reports and a decline in sepsis lethality after the adoption of protocol tools.Keywords: Sepsis, Protocols, Mortality

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Factors predicting the hospital episode costs of emergency medical admissions

Cited by 7 publications

References 24 publications

Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization

Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization

Factors affecting hospital costs and revenue: integrating expert opinions and literature review

Avaliação da aderência ao protocolo de tratamento de sepse em um hospital universitário brasileiro / Assessment of adherence to the sepsis treatment protocol at a Brazilian University Hospital

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