Federal University of Uberlandia, Clinical Hospital, Uberlandia, Brazil.
Institute of Biomedical Sciences, Federal University of Uberlandia, Uberlandia, Brazil.
J Hosp Infect. 2020 Oct;106(2):303-310. doi: 10.1016/j.jhin.2020.07.015. Epub 2020 Jul 18.
Little is known about the economic burden of healthcare-associated infections (HAIs) in Brazil.
To analyse the costs of hospitalization by reimbursement from the Brazilian government, via the Brazilian Unified Health System (SUS) affiliation, and direct costs in the adult Intensive Care Unit (ICU).
The matched-pairs case-control study (83 patients with HAIs and 83 without HAIs) was performed at a referral tertiary-care teaching hospital in Brazil in January 2018. In order to calculate the HAI costs from the perspective of the payer, the total cost for each hospitalization was obtained through the Hospital's Billing Sector. Direct costs were calculated annually for 949 critical patients during 2018.
The reimbursement cost per hospitalization of patients with HAIs was 75% (US$2721) higher than patients without HAIs (US$1553). When a patient has an HAI, in addition to a longer length of stay (15 days), there was an extra increase (US$996) in the reimbursement cost per hospitalization. An HAI in the ICU was associated with a total direct cost eight times higher compared with patients who did not develop infections in this unit, US$11,776 × US$1329, respectively. The direct cost of hospitalization in the ICU without HAI was 56.5% less than the reimbursement (US$1329 × US$3052, respectively), whereas for the patient with an HAI, the direct cost was 111.5% above the reimbursement (US$11,776 × US$5569, respectively).
HAIs contribute to a longer stay and an eight-fold increase in direct costs. It is necessary to reinforce programmes that prevent HAIs in Brazilian hospitals.
巴西的医疗保健相关感染（HAI）的经济负担鲜为人知。
分析通过巴西统一卫生系统（SUS）隶属关系进行政府报销的住院费用和成人重症监护病房（ICU）的直接费用。
2018 年 1 月，在巴西一家三级转诊教学医院进行了配对病例对照研究（83 例 HAI 患者和 83 例无 HAI 患者）。为了从付款人角度计算 HAI 成本，通过医院计费部门获得了每次住院的总费用。2018 年，对 949 名重症患者进行了直接费用的年度计算。
HAI 患者每次住院的报销费用比无 HAI 患者高 75%（2721 美元）。当患者发生 HAI 时，除了住院时间延长（15 天）外，每次住院的报销费用还额外增加了 996 美元。与未在该单位发生感染的患者相比，ICU 中的 HAI 与总直接费用增加了八倍，分别为 11776 美元和 1329 美元。无 HAI 的 ICU 住院直接费用比报销费用低 56.5%（分别为 1329 美元和 3052 美元），而 HAI 患者的直接费用比报销费用高 111.5%（分别为 11776 美元和 5569 美元）。
HAI 导致住院时间延长和直接费用增加八倍。有必要加强巴西医院的 HAI 预防计划。
