PARENTERAL ANTIBIOTIC USAGE PATTERNS AND EFFECTS OF INTRAVENOUS TO ORAL SWITCHING ON THE LENGTH AND COST OF HOSPITALIZATION

Objective: The prolonged use of intravenous antibiotics might increase the length and cost of hospitalization. The research objective, therefore, was toevaluate the effect of switching antibiotics on the length of hospital stay and hospitalization cost. The prospective cohort research design was adopted.The inclusion criteria were in patients who had received intravenous antibiotics.Methods: The sample comprised 39 patients who switched antibiotics as an exposed group and 39 patients who did not switch as an unexposedgroup. The data were collected using the patient medical records and the financial data from the hospital information system. The Mann–Whitney testand Chi-square or Fisher’s exact test was applied in the analysis.Results: The results revealed that the antibiotics most commonly switched were intravenous ceftriaxone (83.3%) and oral cefixime (94.8%). From thefive switching patterns observed, the most common switch was from intravenous ceftriaxone to oral cefixime in patients with acute gastroenteritis.All antibiotics were administered in accordance with the National Formulary (NF) guidelines. Only metronidazole (5 mg/ml dose) was inconsistentwith NF. Switching antibiotics did not impact the length of hospital stay and hospitalization cost; however, comorbidities did have an influence here.Conclusions: Further, switching antibiotics impacted the duration over which intravenous antibiotics were administered and the cost of antibiotics.

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Comparative analysis of cost–effectiveness between isosorbide-5-mononitrate and isosorbide: a retrospective real-world evaluation

Journal of Comparative Effectiveness Research ◽

10.2217/cer-2019-0099 ◽

2020 ◽

Vol 9 (6) ◽

pp. 405-412

Author(s):

Guimin Zhang ◽

Xinling Liu ◽

Jian Xu ◽

Guoliang Cheng ◽

Juntang Xu

Keyword(s):

Cost Effectiveness ◽

Hospital Stay ◽

Real World ◽

Length Of Hospital Stay ◽

Clinical Aspects ◽

Sublingual Nitroglycerin ◽

Hospitalization Cost ◽

Tertiary Hospitals ◽

Main Component ◽

The Cost

Aim: The cost–effectiveness of isosorbide-5-mononitrate (5-ISMN) and isosorbide dinitrate (ISDN) in real-world use in patients with coronary heart disease (CHD; either angina pectoris or myocardial infarction) was retrospectively compared. Method: In this retrospective real-world evaluation, patients with established CHD satisfying the following criteria were selected from information system of two tertiary hospitals in China: with pharmacy claiming for at least one injection of 5-ISMN or ISDN between July 2008 and May 2017; and, CHD patients. By using propensity score matching (PSM), we compared clinical aspects of efficacy, safety, length of hospital stay and cost during hospitalization between 5-ISMN and ISDN group. All data were processed by R statistical package v.2.13.1 (R Foundation for Statistical Computing, Vienna, Austria). Result: Of 5609 patients selected, 4047 received 5-ISMN and 1562 received ISDN. After PSM, we acquired 1555 pairs based on balancing of age, sex, insurance and comorbidities on admission. The frequency (4.2 ± 6.6-times vs 6.5 ± 9.5-times; p < 0.05) and total dosage (47.5 ± 153.4 vs 136.4 ± 261.0 mg; p < 0.05) of sublingual nitroglycerin use decreased and hypotension incidence lowered (8.0 vs 13.0%; p < 0.05) in 5-ISMN group compared with ISDN group. Hospital stay (16.0 ± 11.3 days vs 17.7 ± 13.2; p < 0.05) and hospitalization expenditure ([the ratio of cost in the study to the average hospitalization cost in the city] [odds ratio: 2.5 vs 2.6; p < 0.05]) were reduced in 5-ISMN group as with that of ISDN group. Moreover, the main component of hospitalization cost was medical consumables and medications in both the groups. Conclusion: In the present retrospective real-world evaluation, by using PSM analysis, we found that newer injection agent of 5-ISMN was associated with fewer use of sublingual nitroglycerin, less hypotension incidence, shorter length of hospital stay and less hospitalization expenditure related to its comparator ISDN in patients with established CHD. Further evaluation and clinical experience are need in different circumference for the usage of ISDN.

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Locked intramedullary nailing technique of the femur without brilliance amplifier at the trauma and orthopedics department of the university hospital of peace series on 35 cases during 1 year

MOJ Orthopedics & Rheumatology ◽

10.15406/mojor.2021.13.00556 ◽

2021 ◽

Vol 13 (5) ◽

pp. 95-97

Author(s):

Augustin Delange Hendrick ◽

Almenord Pharol ◽

Khawly Clifford PG ◽

Augustin Delange ◽

Pierre Marie Woolley

Keyword(s):

Hospital Stay ◽

Intramedullary Nailing ◽

Femoral Fractures ◽

Length Of Hospital Stay ◽

University Hospital ◽

Patient Morbidity ◽

Duration Of Hospitalization ◽

The Cost ◽

The University

Femoral fractures increase the length of hospital stay for our patients for several reasons such as lack of blood, economic resources, and lack of infrastructure. The use of a C-arm has been shown to reduce patient morbidity due to early functional recovery and reduced hospital stay. Objective: To develop an intramedullary nailing technique without c-arm with a closed focus to reduce the duration of hospitalization of its patients as well as the cost related to the equipment used for follow-up. Methodology: prospective study on 35 patients for 1 year August 2020 to August 2021 Results: We followed 35 patients in which the mean age was 37.83 years with extremes of 18 and 78 years. The male sex predominates 21 against 14 women or 60% against 40% respectively. The sex ratio is 1.5. A total of 19 diaphyseal fractures (54.3%) were nailed, 9 supracondylar (25.7%) and 7 subtrochanteric (20%). Twenty-seven were closed fractures (71.1%), and 8 were open fractures (22.9%). The length of hospitalization was less than 3 days for 30 patients (85.7%), and more than 3 days for 5 patients (14.3%). Conclusion: We recommend that we promote this closed-hearth technique because it improves the postoperative follow-up of patients. Additionally, it would reduce exposure to radiation from c-arm in hospitals that have this equipment.

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Analysis of Contingency Tables with Sparse Values

Journal of Marketing Research ◽

10.1177/002224377901600310 ◽

1979 ◽

Vol 16 (3) ◽

pp. 382-386 ◽

Cited By ~ 5

Author(s):

William S. Shields ◽

Roger M. Heeler

Keyword(s):

Contingency Tables ◽

Fisher Exact Test ◽

Financial Cost ◽

Chi Square ◽

Exact Test ◽

Loss Of Information ◽

Cell Counts ◽

Chi Square Analysis ◽

The Cost

In the chi square analysis of cross-tabulated variables, the problem of low cell counts is usually solved by combining categories, at the cost of a loss of information, or by using larger samples, at added financial cost. Use of a chi square statistic based on an extension of the Fisher Exact Test can provide a third, less costly, alternative.

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International multi-centre study of incidence and risk factors of symptomatic deep venous thrombosis (DVT) and or pulmonary embolism (PE) in prostate cancer patients undergoing laparoscopic radical prostatectomy (LRP)

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.8555 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 8555-8555 ◽

Cited By ~ 1

Author(s):

F. P. Secin ◽

G. Fournier ◽

I. S. Gill ◽

C. C. Abbou ◽

C. Schulmann ◽

...

Keyword(s):

Risk Factors ◽

Hospital Stay ◽

Operating Time ◽

Length Of Hospital Stay ◽

Lung Ventilation ◽

The United States ◽

P Value ◽

Tobacco Exposure ◽

Multi Centre Study ◽

Exact Test

8555 Background: There is no data regarding the incidence and variables associated with symptomatic DVT and or PE in patients undergoing LRP. Our aim was to evaluate the multi-centric incidence and risk factors for perioperative symptomatic DVT and PE after LRP. Methods: Patients with symptomatic DVT and or PE occurring within 2 months of surgery since start of the respective institutional LRP experience were included. Eight academic centers from both the United States and Europe participated. Diagnoses were made by Doppler ultrasound for DVT; and lung ventilation/perfusion scan and or chest computed tomography for PE. Associations between variables and DVT and/or PE were evaluated using Fisher’s exact test for categorical predictors and logistic regression for continuous predictors. Results: Patient reoperation (p value) (<0.001), tobacco exposure (0.02), prior DVT (0.007), larger prostate size (0.02) and length of hospital stay (0.009) were significantly associated with higher risk of symptomatic DVT/PE. The nonuse of perioperative heparin was not a risk factor (1), as well as neoadjuvant therapy (1), perioperative transfusion (0.1), body mass index (0.9), surgical technique (0.3), operating time (0.2) and pathologic stage (0.5). There were no related deaths. Patients receiving preoperative heparin had significantly higher mean operative blood loss, 480cc vs 332cc (<0.001) However, this did not translate into longer hospital stay (0.07); higher transfusion rates (0.09) or reoperation rates (0.3). The estimated cost of heparin prophylaxis in these patients exceeded $2.5 million. Conclusion: The incidence of symptomatic DVT or PE was similar despite different prophylactic regimens. Our data does not support the administration of prophylactic heparin in LRP to low risk patients (no prior DVT, no tobacco exposure, no prostate enlargement and or no anticipation of prolonged hospital stay). [Table: see text] No significant financial relationships to disclose.

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Cost of hospitalization for stroke in a low–middle-income country: Findings from a public tertiary hospital in the Philippines

International Journal of Stroke ◽

10.1177/1747493020906872 ◽

2020 ◽

pp. 174749302090687 ◽

Cited By ~ 2

Author(s):

Jose Danilo Bengzon Diestro ◽

Abdelsimar Tan Omar ◽

Robert Joseph Cruz Sarmiento ◽

Clare Angeli Guinto Enriquez ◽

Lennie Lynn Chua-De Castillo ◽

...

Keyword(s):

Acute Stroke ◽

Surgical Intervention ◽

Length Of Hospital Stay ◽

Intravenous Thrombolysis ◽

Tertiary Hospital ◽

The Philippines ◽

Hospitalization Cost ◽

Male Sex ◽

Stroke Type ◽

The Cost

Background Determining the cost of hospitalization for acute stroke is important in the appropriate allocation of resources for public health facilities and in the cost effectiveness analysis of interventions. Despite being the second leading cause of mortality in the Philippines, there are no published data on the cost of stroke in the country. Aim The study aims to determine the in-hospitalization cost for stroke (IHCS) in a tertiary public hospital in the Philippines and identify the factors influencing IHCS. Methods The study was a retrospective review of the medical and billing records of the hospital. Adult patients admitted for acute stroke between 1 June 2017 and 31 May 2018 were included in the analysis. After the mean cost of stroke was determined, multivariate logistic regression analysis was done to determine demographic and clinical characteristics that were predictive of stroke cost. Results A total of 863 patient records were analyzed. The median in-hospitalization cost for stroke was PHP 17,141.50 or US$329.52. Independent determinants of higher cost include male sex (p = 0.021), stroke type (hemorrhagic stroke, p = 0.001; subarachnoid hemorrhage, p < 0.001), lower GCS on admission (p = 0.023), surgical intervention (p < 0.001), intravenous thrombolysis (p < 0.001), infection (p < 0.001), length of hospital stay (p < 0.001), and mechanical ventilation (p = 0.008). Conclusion The study provided current data on the in-hospitalization cost of acute stroke in a public tertiary hospital in the Philippines. Male sex, stroke type, lower GCS on admission, surgical intervention, intravenous thrombolysis, infection, length of hospital stay, and mechanical ventilation were independent predictors of cost.

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Predicting length of hospital stay and cost by aneurysm grade on admission

Journal of Neurosurgery ◽

10.3171/jns.1996.85.3.0388 ◽

1996 ◽

Vol 85 (3) ◽

pp. 388-391 ◽

Cited By ~ 26

Author(s):

J. Paul Elliott ◽

Peter D. Le Roux ◽

Galen Ransom ◽

David W. Newell ◽

M. Sean Grady ◽

...

Keyword(s):

Hospital Stay ◽

Treatment Cost ◽

Significant Proportion ◽

Length Of Hospital Stay ◽

Aneurysm Rupture ◽

Clinical Grade ◽

Content Type ◽

Factors Affecting ◽

Hospitalization Costs ◽

The Cost

✓ To determine the relationship between clinical grade on admission and treatment cost after aneurysm rupture, the authors retrospectively examined the length of hospital stay (LOS) and total hospitalization costs (excluding professional fees) for 543 patients admitted for aneurysm surgery between 1983 and 1993. The overall median LOS was 18 days, with a range of 1 to 165 days. Increased median LOS correlated with Hunt and Hess Grades 0 to IV on admission (p< 0.001). Median LOS for Grade V patients was reduced, in part, because of early mortality. Increased treatment cost also correlated with worse admission clinical grade (p < 0.001). A significant proportion of total expenditures occurred early in the hospitalization for patients in all clinical grades. Identification of additional factors affecting the cost of aneurysm treatment is indicated to complement treatment outcome studies.

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Magyarországon végzett infrarenalis aortaaneurysma-műtétek eredményei az Érsebészeti Regiszter adatai alapján (2010–2014)

Orvosi Hetilap ◽

10.1556/650.2015.30309 ◽

2015 ◽

Vol 156 (49) ◽

pp. 1991-2002 ◽

Cited By ~ 2

Author(s):

László Hidi ◽

Gábor Menyhei ◽

Tamás Kováts ◽

Adrienn Dobai ◽

Zoltán Szeberin

Keyword(s):

Aortic Aneurysm ◽

Hospital Stay ◽

Endovascular Repair ◽

High Capacity ◽

Length Of Hospital Stay ◽

Perioperative Mortality ◽

Exact Test ◽

Infrarenal Aortic Aneurysm ◽

The Past ◽

Calculation Results

Introduction: The Hungarian Society for Vascular Surgery decided to analyse and publish regularly the data of the Hungarian Vascular Registry. Aim: The aim of the authors was to present the outcome of infrarenal aortic aneurysm surgeries performed during the past five years. Method: Prospectively collected multicentric data obtained from the Hungarian Vascular Registry between January 1, 2010 and December 31, 2014 were analysed retrospectively. Statistical analysis was performed using Fisher’s exact test and odds ratio calculation. Results: It was found that 16.72% of the 1435 operations were performed for ruptured aneurysms. Five institutes having the highest capacity performed 78.4% of the operations. In the ruptured aortic aneurysm group the age of patients was 71.77±9.82 years (mean±SD), and perioperative mortality was 33.75%. In the intact aortic aneurysm group the age of patients was 69.50±8.46 years and the perioperative mortality was 3.51%. In both groups perioperative mortality (ruptured: p<0,05, OR = 0.11; intact: p<0.05, OR = 0.26) and the length of hospital stay (ruptured: p<0.05, OR = 4.55; intact: p<0.001, OR = 4.27) were significantly lower in patients who had endovascular repair compared to those with open repair. In both groups perioperative mortality (ruptured: p<0.0001, OR = 0.32; intact: p<0.0001, OR = 0.23) and length of hospital stay (ruptured: p<0.05, OR = 3.16; intact: p<0.001, OR = 3.84) were significantly lower in the five institutes having the highest capacity than in the remaining institutes. Conclusions: In patients having endovascular repair and in institutes with high capacity the perioperative mortality and length of hospital stay were significantly lower. Orv. Hetil., 2015, 156(49), 1991–2002.

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Distribution and cost of Syrian refugees operated on in Southeastern Anatolia, Turkey

Eastern Mediterranean Health Journal ◽

10.26719/emhj.21.075 ◽

2021 ◽

Vol 27 (12) ◽

pp. 1137-1411

Author(s):

Fatih Cakmak ◽

Afsin Ipekci ◽

Banu Karakus Yilmaz ◽

Serap Biberoglu ◽

Yonca Akdeniz ◽

...

Keyword(s):

Hospital Stay ◽

Health Spending ◽

Length Of Hospital Stay ◽

Care Hospital ◽

Syrian Refugees ◽

Refugee Status ◽

Body Regions ◽

Syrian Civil War ◽

The Cost ◽

Duration Of Operation

Background: As a result of the Syrian civil war, > 5 million Syrian citizens have fled to neighbouring countries, particularly Turkey, under refugee status. Aims: To analyse the cost and justification for surgery of Syrian refugees treated in a secondary care hospital in Sanliurfa, Southeastern Turkey, close to the Syrian border. Methods: We enrolled 1458 Syrian refugees who were operated upon between 2012 and 2015. The data were obtained through a retrospective search of the hospital information system. Patients were divided into traumatic and nontraumatic cases. Injured body regions, anaesthetic technique, duration of operation, length of hospital stay, sociodemographic features and treatment cost were recorded and analysed. Results: Length of the hospital stay was 7.66 (0.31) days for all 1458 patients. The most common operations were orthopaedic, urological and cranial surgery. The total healthcare costs while patients stayed in hospital was ~US$ 2 million, and cost per patient was US$ 1400. Conclusions: The number of trauma operations performed has declined between 2012 and 2015. Health spending on refugees is an indicator of the economic burden on the country

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Ban Bedcentricity: a Multifaceted Innovation to Reduce Sedentary Behavior of Patients During the Hospital Stay

Physical Therapy ◽

10.1093/ptj/pzab054 ◽

2021 ◽

Author(s):

Niek Koenders ◽

Sandra Potkamp-Kloppers ◽

Yvonne Geurts ◽

Reinier Akkermans ◽

Maria W G Nijhuis-van der Sanden ◽

...

Keyword(s):

Hospital Stay ◽

Sedentary Behavior ◽

Length Of Hospital Stay ◽

Cardiothoracic Surgery ◽

Discharge Destination ◽

Chi Square ◽

Behavioral Observations ◽

Significant Difference ◽

Before And After ◽

Ward Level

Abstract Objective The purpose of this study was to explore differences in sedentary behavior, length of hospital stay, and discharge destination of patients before and after the Ban Bedcentricity implementation at ward-level. Methods The Ban Bedcentricity innovation and implementation procedure were implemented at the cardiothoracic surgery, cardiology, and orthopedics-traumatology wards. Sedentary behavior data were collected 2 weeks before and after the implementation using behavioral observations and analyzed with Pearson’s chi-square. Length of hospital stay and discharge destination data were collected from all admitted patients and analyzed with multiple and logistic regression analyses. Results Behavioral observations showed that in 52% of the observations patients were lying in bed before implementation and 40% after implementation at the cardiothoracic surgery, 64% and 46% at the cardiology, and 53% and 57% at the orthopedics-traumatology wards. The mean length of hospital stay after implementation (compared to before implementation) was 5.1 days at the cardiothoracic surgery (n = 1923; mean + +0.13 days; 95%CI = −0.32 to +0.60), 2.6 days at the cardiology (n = 2646; mean = −0.22 days; 95%CI = −0.29 to −0.14), and 2.4 days at the Orthopedics-Traumatology wards (n = 1598; mean = +0.28 days = 95%CI = +0.06 to +0.50). After the implementation, more patients were discharged home from the cardiothoracic surgery (odds ratio [OR = 1.23]; 95%CI = 1.07 to 1.37) and cardiology wards (OR = 1.37; 95%CI = 1.22 to 1.49), and no statistically significant difference was found at the orthopedics-traumatology ward (OR = 1.09; 95%CI = 0.88 to 1.27). Conclusions The outcomes indicate beneficial outcomes after the implementation with less sedentary behavior and proportionately more patients being discharged home, compared to before the implementation. However, little information is available about the adoption and fidelity of Ban Bedcentricity, therefore, outcomes should be interpreted with caution. Impact This multifaceted innovation to reduce sedentary behavior of patients during the hospital stay seems to be promising, with outcomes indicating less sedentary behavior in patients and more patients being discharged home after the implementation.

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COVID in women in Brazil: length of stay and outcomes of first hospitalizations

Rev Rene ◽

10.15253/2175-6783.20212261049 ◽

2021 ◽

Vol 22 ◽

pp. e61049

Author(s):

Erica de Brito Pitilin ◽

Maicon Henrique Lentsck ◽

Vanessa Aparecida Gasparin ◽

Larissa Pereira Falavina ◽

Vander Monteiro da Conceição ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Length Of Stay ◽

Hospital Stay ◽

Ecological Study ◽

Length Of Hospital Stay ◽

Secondary Diagnosis ◽

Chi Square ◽

Hospital Stays ◽

Underlying Diseases

Objective: to analyze the length of hospital stay and outcomes of the first hospitalizations due to COVID-19 of women at the beginning of the pandemic. Methods: ecological study with data on COVID-19 hospitalizations of women. Data classification was done by states, regions, age, length of hospital stay, main and secondary diagnosis (underlying diseases), and outcome. Kruskal-Wallis, Mann-Whitney, and chi-square tests were used for the analysis. Results: the Southeast region had the highest number of hospitalizations (0.6%). Of the total number of hospitalizations, 14.6% required an intensive care unit. The length of hospital stay of women over 50 years was significant for Brazil (p<0.001). There was an association between length of hospital stay and levels 2 and 3 of comorbidity. Deaths in women over 50 years old were significant in Brazil, Northeast, and Southeast (p<0.001). Conclusion: women over 50 years old with comorbidities are associated with longer hospital stays and deaths.

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