Escuela de Graduados, Universidad CES, Medellín, Colombia; Departamento de Pediatría, Clínica Universidad de La Sabana, Universidad de La Sabana, Chía, Colombia.
Escuela de Graduados, Universidad CES, Medellín, Colombia.
Biomedica. 2021 Mar 19;41(1):87-98. doi: 10.7705/biomedica.5196.
Introduction: Half of the episodes of neonatal sepsis are acquired in the community with a high percentage of mortality and complications. Objective: To estimate the direct costs of hospitalizations due to systemic neonatal infection acquired in the community in low-risk newborns. Materials and methods: For the estimation of costs, we used the perspective of the health systems and the microcosting technique and we established the duration of hospitalization as the time horizon. We identified cost-generating events through expert consensus and the quantification was based on the detailed bill of 337 hospitalized newborns diagnosed with neonatal infection. The costs of the medications were calculated based on the drug price information system (SISMED) and the ISS 2001 rate manuals adjusting percentage, and the mandatory insurance rates for traffic accidents (SOAT). We used the bootstrapping method for cost distribution to incorporate data variability in the estimate. Results: We included the medical care invoices for 337 newborns. The average direct cost of care per patient was USD$ 2,773,965 (Standard Deviation, SD=USD$ 198,813.5; 95% CI: $ 2,384,298 - $ 3,163,632). The main cost-generating categories were hospitalization in intensive care units and health technologies. The costs followed a log-normal distribution. Conclusions: The categories generating the greatest impact on the care costs of newborns with infection were hospitalization in neonatal units and health technologies. The costs followed a log-normal distribution.
新生儿败血症有一半是在社区获得的,其死亡率和并发症发生率都很高。目的:估计在低危新生儿中,社区获得性全身新生儿感染住院的直接费用。材料和方法:为了估算成本,我们采用了卫生系统的视角和微观成本核算技术,并将住院时间定为时间范围。我们通过专家共识确定了成本产生事件,量化则基于 337 名被诊断为新生儿感染的住院新生儿的详细账单。药物成本是根据药物价格信息系统(SISMED)和 2001 年国际疾病分类(ICD-10)手册调整的百分比以及强制性交通事故保险费率(SOAT)计算的。我们使用 bootstrap 方法进行成本分配,以纳入估计中的数据变异性。结果:我们纳入了 337 名新生儿的医疗费用发票。每位患者的平均直接护理成本为 2773965 美元(标准差,SD=198813.5 美元;95%置信区间:2384298 美元-3163632 美元)。主要的成本产生类别是重症监护病房和卫生技术的住院治疗。成本呈对数正态分布。结论:对感染新生儿护理成本产生最大影响的类别是新生儿病房和卫生技术的住院治疗。成本呈对数正态分布。