Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Division of Neonatal Medicine, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2023 Aug 28;78:100277. doi: 10.1016/j.clinsp.2023.100277. eCollection 2023.
To evaluate the hospital cost of newborn infants diagnosed with sepsis from the perspective of the Brazilian Public Health System over 11 years.
Cross-sectional study that analyzed secondary data from the databases of the Hospital Information System of the Brazilian Public Health System. Infants hospitalized between 0‒29 days after birth with a diagnosis of sepsis from 2008 to 2018 were included. The diagnosis used in the study was the one that the hospital considered the main diagnosis at admission. Costs were analyzed in US dollars and reflected the amount paid by the Brazilian Public Health System to the hospitals for the informed diagnosis upon admission. The costs were evaluated as the total per admission, and they were compared among Brazilian geographic regions, among etiologic agents, and between neonates with the diagnosis of sepsis that survived or died.
From 2008 to 2018, 47,554 newborns were hospitalized with sepsis (148.04 cases per 100,000 live births), with an average cost of US$ 3345.59 per hospitalization, ranging from US$ 2970.60 in the North region to US$ 4305.03 in the Midwest. Among sepsis with identified agents, the highest mean cost was related to Gram-negative agents, and the lowest to Streptococcus agalactiae sepsis. Patients with sepsis who died had a higher cost than the survivors (t-test; p = 0.046).
The evaluation of costs related to neonatal sepsis in the country during an 11-year period shows the economic impact of morbidity that may be avoided by improving the quality of neonatal care.
从巴西公共卫生系统的角度评估 11 年来诊断为败血症的新生儿的医院费用。
这是一项横断面研究，分析了巴西公共卫生系统医院信息系统数据库中的二级数据。研究纳入了 2008 年至 2018 年出生后 0-29 天住院且诊断为败血症的婴儿。本研究中使用的诊断是医院在入院时认为的主要诊断。费用以美元计算，反映了巴西公共卫生系统支付给医院的告知性诊断费用。费用作为每次住院的总费用进行评估，并在巴西地理区域之间、病原体之间以及存活和死亡的败血症新生儿之间进行比较。
2008 年至 2018 年，共有 47554 名新生儿因败血症住院（每 100000 例活产中有 148.04 例），每次住院的平均费用为 3345.59 美元，从北部地区的 2970.60 美元到中西部地区的 4305.03 美元不等。在确定病原体的败血症中，革兰氏阴性菌相关的平均费用最高，而无乳链球菌败血症的费用最低。死亡的败血症患者的费用高于幸存者（t 检验；p=0.046）。
对巴西 11 年来新生儿败血症相关成本的评估表明，通过提高新生儿护理质量，可以避免发病率带来的经济影响。
