The Economic Impact of Carbapenem Resistant-Non Lactose Fermenter and Enterobacteriaceae Infections on Hospital Costs in Dr. Soetomo General Academic Hospital Surabaya, Indonesia

Abstract

Background: Carbapenem resistant-non lactose fermenter (CR-NLF) and Carbapenem resistant-Enterobacteriaceae (CR-E) bacterial infections are likely to be a global threat to people’s health. However, studies on the economic impacts according to the hospital setting are very scarce. The study aimed to explore the impact of CR-NLF (Acinetobacter baumannii = CRAB) & Pseudomonas aeruginosa = CRPA) and CR-E (Escherichia coli = CREC) & Klebsiella pneumoniae = CRKP) infections on hospital costs from a payer perspective among patients admitted to Dr.Soetomo Hospital, Surabaya, Indonesia. Methods: In the retrospective case-control study, medical records of all included patients hospitalized during 2018–2021 were reviewed for CRAB, CRPA, CREC, CRKP, and carbapenem sensitive (CSAB, CSPA, CSEC, CSKP) were collected. We retrieved the data of age, gender, clinical specimen, dates of admission, and discharge status. The outcomes of interest were hospital length of stay and hospitalization cost. Results: The cost for CR-NLFs infections was higher than carbapenem sensitive, $3026.24 versus $1299.28 (p < 0.05). There was no significant difference between CR-E against carbapenem sensitive. It showed that the highest impact of the cost was CRAB, followed by CRPA, CRKP, and CREC. The bed, antibiotics, pharmacy, and diagnostic costs of CR-NLFIs were significantly higher than CR-E. Conclusion: This study showed that the hospital cost and expenditure of CR-NLFs per patient were higher than CS. The hospital cost per patient for CR-NLF was higher than CR-E.

Knowledge and attitudes towards antibiotic resistance among health profession students in Indonesia

“…Increasing antimicrobial resistance reduces drug efficacy and makes treating patients complicated and expensive [7], which results in prolonged illness and increased mortality [8], [9]. The problem that often occurs is when patients do not comply with the rules of taking medication so that resistance occurs.…”

The relationship between workload and nurses’ performance in carrying out nursing care in inpatient at Hospital, Riau Province, Indonesia

“…The hospital is an institution that provides comprehensive health services for individuals who provide services, including inpatient, outpatient, and emergency services (2)(3)(4). As a health service center, hospitals must provide safe, effective, and quality health services for their patients (5)(6)(7).…”

Antibacterial activity of Indonesian Bidara Upas Tuber (Merremia Mammosa L.) against pathogen bacteria

“…The COVID-19 pandemic has increased the death rate from infectious diseases in the world and Indonesia (2). One of the diseases that many Indonesian people have suffered since ancient times is an infectious disease (3)(4)(5)(6). Infectious diseases can be caused by pathogenic microorganisms, such as Streptococcus sp., Pseudomonas aeruginosa, E. coli ESBL, and Methicillin-Resistant Staphylococcus aureus (MRSA) (7)(8)(9)(10).…”