Hospital Treatment Costs and Factors Affecting These Costs in Community-Acquired Pneumonia

The importance of state monitoring of water bodies on parasitological indicators is actualized in the article. It was established that summary reports of federal enterprises involved in the state monitoring of water bodies are formed without taking into account natural parasitic systems and insufficient detection of local parasitological pollution. At the same time, the incidence rate in the Russian Federation regarding giardiasis due to the water transport factor has been consistently high for several years. Cryptosporidiosis among the population is not detected due to the use of insensitive methods of diagnosis. With such an unexplored state of factors affecting public health, the level of unidentified etiological causes of acute intestinal infections, upper respiratory tract infections, and community-acquired pneumonia remains high in the Russian Federation: 70% and 90%, respectively. The article presents data on parasitic contamination of water bodies in the catchment area of the Moskva River, obtained with an independent expert survey.

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Radiographically Confirmed Community-Acquired Pneumonia in Pediatric Patients Prior to Pneumococcal Vaccination in Nepal

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0037-1607266 ◽

2017 ◽

Vol 13 (01) ◽

pp. 057-062

Author(s):

Dhruba Shrestha ◽

Ganendra Raya ◽

Amar Prajapati ◽

Suruchi Dhaubhadel ◽

Sushmita Puri ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Pleural Effusion ◽

Intensive Care Unit Admission ◽

Pneumococcal Vaccination ◽

Community Acquired Pneumonia ◽

Blood Cultures ◽

Hospital Treatment ◽

High Morbidity ◽

Rural Nepal

Background The massive burden of pediatric pneumonia is associated with high morbidity and mortality, particularly in developing countries where immunization programs are absent or recently been implemented. The objective of this study was to describe the number of hospitalizations and outcomes of children aged 1 month to 10 years with community-acquired pneumonia (CAP) between January 1, 2014, and June 30, 2015, in semi-rural Nepal. Methods This retrospective study was undertaken prior to the implementation of the pneumococcal conjugate vaccination (PCV) program in Bhaktapur district of Nepal. Chart review of children with CAP, defined as the presence of symptoms, physical examination findings compatible with bacterial pneumonia together with lobar consolidation on chest X-ray (CXR), was performed. Data extracted included laboratory parameters and blood cultures on admission, antibiotic treatment, and length of hospital stay, as well as complications, such as death, intensive care unit admission, pleural effusion, and empyema. Outcomes assessed were clinical improvement accompanied by radiological improvement of consolidation. Results During the study period, 367 patients were admitted with pneumonia, of which, 74 (20%) had definite CXR evidence of lobar pneumonia. A total of 86.5% of the cases were children < 5 years of age. Admission blood cultures from all patients were negative. More than 80% of patients had white blood cell (WBC) counts >11,000/mm3 and ≥ 75% neutrophils. The highest number of cases presented between February and July. Forty-three of 45 patients responded to crystalline penicillin (CP), and 25/27 patients treated with cefotaxime also responded; the mean duration of treatment was 10 ± 2.3 days. There were no deaths. None of the patients developed empyema, sepsis, or pleural effusion or required intensive care unit admission. Conclusions CAP in pre-PCV semi-rural Nepal mostly affects male children < 5 years old and peaks between March and May. In-hospital treatment with CP or cefotaxime is effective.

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Factors affecting short and long-term mortality after community-acquired pneumonia

10.1183/13993003.congress-2015.pa2565 ◽

2015 ◽

Author(s):

Fatma Tokgöz Akyil ◽

Armagan Hazar ◽

Murat Yalçinsoy ◽

Aykut Çilli ◽

Burcu Çelenk ◽

...

Keyword(s):

Community Acquired Pneumonia ◽

Factors Affecting ◽

Short And Long Term ◽

Long Term Mortality

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Hospital treatment costs and length of stay associated with hypertension and multimorbidity after hemorrhagic stroke

BMC Neurology ◽

10.1186/s12883-017-0930-2 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 15

Author(s):

Adrian V. Specogna ◽

Tanvir C. Turin ◽

Scott B. Patten ◽

Michael D. Hill

Keyword(s):

Length Of Stay ◽

Hemorrhagic Stroke ◽

Treatment Costs ◽

Hospital Treatment

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TREATMENT COSTS FOR COVID-19 PATIENTS IN A TERTIARY HOSPITAL FROM SERBIA

10.1101/2021.11.30.21267085 ◽

2021 ◽

Author(s):

Predrag S. Sazdanovic ◽

Slobodan Milisavljevic ◽

Dragan R. Milovanovic ◽

Slobodan M. Jankovic ◽

Dejan Baskic ◽

...

Keyword(s):

Fatal Outcome ◽

Tertiary Hospital ◽

Treatment Costs ◽

Hospital Treatment ◽

Insurance Fund ◽

Southeast Europe ◽

Middle Income ◽

Tertiary Center ◽

Illness Study ◽

Comorbidity Index

ABSTRACTIntroductionAim of our study was to identify total costs of COVID-19 inpatients treatment in an upper-middle income country from Southeast Europe.MethodsThis retrospective, observational cost of illness study was performed from National Health Insurance Fund perspective and included a cohort of 118 males and 78 females admitted to COVID-19 ward units of a tertiary center, during the first wave of epidemics.ResultsThe median of total costs in the non-survivors’ subgroup (n=43) was 3279.16 Euro (4023.34, 355.20, 9909.61) which is higher than in the survivors (n=153) subgroup 747.10 Euro (1088.21, 46.71, 3265.91). The odds ratio of Charlson Comorbidity Index total score and every 100-Euros increase of patient’s total hospital treatment costs for fatal outcome were 1.804 (95% confidence interval 1.408-2.311, p<0.001) and 1.050 (1.029-1.072, p<0.001), respectively.ConclusionsDirect medical treatment costs for COVID-19 inpatients represent significant economic burden. The link between increased costs and unfavorable final outcome should be further explored.

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Community-acquired pneumonia in patients with chronic heart failure: clinical manifestation and a diagnostic role of biomarkers

Russian Pulmonology ◽

10.18093/0869-0189-2019-29-4-391-402 ◽

2019 ◽

Vol 29 (4) ◽

pp. 391-402

Author(s):

A. A. Bobylev ◽

S. A. Rachina ◽

S. N. Avdeev ◽

R. S. Kozlov

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Clinical Course ◽

Respiratory Infections ◽

Community Acquired Pneumonia ◽

Serum Biomarkers ◽

Hospital Treatment ◽

Tnf Α ◽

Echocardiographic Parameters

The aims of this study were to evaluate clinical course of community-acquired pneumonia (CAP) in patients with chronic heart failure (CHF) and to assess the time course of serum biomarkers, such as C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), and brain natriuretic peptide (BNP), at baseline and after treatment in patients with CAP and CHF. Methods. This was a prospective observational study. Adult patients with CHF admitted to a hospital due to suspected CAP were recruited in the study. The diagnosis of CAP was confirmed by chest computed tomography (CT). Subsequently, patients were assigned to the group 1 (with confirmed CAP) or the group 2 (with respiratory infections other than CAP). Echocardiography was performed in all patients at baseline and in follow-up visits. In addition to the routine clinical examination and laboratory tests, serum biomarkers were measured in all patients at admission (Visit 1), at days 10 to 14 (Visit 2), and at days 28 to 42 (Visit 3). Standard statistical methods were used for data analysis. Results. Seventy patients who met the inclusion criteria were enrolled in this study; of them, 35 patients had confirmed CAP and 35 patients had respiratory infections other than CAP. Both groups were similar for demographic and clinical characteristics, as well as for laboratory, echocardiographic and radiological findings. CAP did not affect the clinical course of CHF and echocardiographic parameters did not differ significantly between the groups. Clinical signs of both diseases improved after the treatment in majority of patients. Echocardiographic parameters also improved in both groups that indicates the improvement in cardiac dysfunction under the treatment. During the follow-up, the most prominent changes were seen in CRP level which was significantly higher at baseline in CAP patients compared to patients with other respiratory infections. CRP level decreased at Visit 2 in both groups and in Visit 3 in CAP group. CRP levels differed significantly between the groups both at Visits 1 and 2. Other biomarkers, such as PCT, IL-6, and BNP, were significantly higher at Visit 1 compares to Visit 2. TNF-α level did not change significantly neither in any group during the study nor between the groups at any study time. Conclusion. CAP did not affect the clinical course of CHF. Inflammatory biomarkers, such as CRP, PCT, and IL-6, could be used additionally to the routine diagnostic procedures to differentiate between CAP and other respiratory infections in patients with CHF. CRP is the most promising biomarker. Serum levels of the biomarkers decreased significantly under the standard hospital treatment of CAP and CHF; this could be considered to evaluate treatment success and prognosis.

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Microbial landscape in hospital patients with new coronavirus disease (COVID-19), antibiotic resistance comparison vs. Pre-covid stage: a prospective study

Kuban Scientific Medical Bulletin ◽

10.25207/1608-6228-2021-28-5-14-28 ◽

2021 ◽

Vol 28 (5) ◽

pp. 14-28

Author(s):

Marina G. Avdeeva ◽

Makka I. Kulbuzheva ◽

Sergey V. Zotov ◽

Yelena V. Zhuravleva ◽

Alina V. Yatsukova

Keyword(s):

Antibiotic Resistance ◽

Community Acquired Pneumonia ◽

Patient Treatment ◽

Hospital Treatment ◽

Gram Positive ◽

Gram Negative ◽

Hospital Patients ◽

Coronavirus Infection ◽

Low Incidence ◽

A Prospective Study

Background. The new coronavirus infection has manifested untypically compared to other acute respiratory agents, posing a major challenge to researchers worldwide. Despite low incidence of bacterial complications, microbial coinfection plays an important role in the onset and development of severe COVID-19 to hamper diagnosis, treatment and prognosis.Objectives. A study of microbial landscape in secondary complications of COVID-19 and prevailing microbial-agent antibiotic resistance dynamics in COVID-19 vs. patients with pre-COVID community-acquired pneumonia.Methods. We analysed 1,113 bacterial sputum cultures in COVID-19 patients from 21 hospital of Krasnodar Krai. The study sample comprised 524 strains isolated from COVID-19 patients in bacteriological assays. The comparison sample included 643 positive sputum strains isolated from community-acquired pneumonia patients developing disease in outcome of acute respiratory infection in 2015–2018. The microbial aetiology landscape and strain antibiotic resistance have been compared in COVID-19 vs. patients with community-acquired pneumonia.Results. Gram-negative bacteria predominated in COVID-19 cultures (58%), followed by Gram-positive bacteria (15%) and fungi (27%). Acinetobacter baumannii (35%) and Klebsiella pneumoniae (33%) were about equally represented in Gram-negative flora, Pseudomonas aeruginosa (19%) and other microorganisms were half as common. Streptococcus pneumonia and Staphylococcus aureus accounted for 48 and 15% Gram-positive strains, respectively. Sputum-isolated fungi were mainly identifi ed as Candida albicans (89%). The Streptoccocus pneumoniae detection rate dropped to 7% in 2020 relative of other flora, which is 10 times less vs. pre-COVID rates, whilst the fungal rate increased dramatically. Antibiotic resistance increased in most isolated microbial strains.Conclusion. A Gram-negative-dominated aetiology of lower respiratory tract lesions, as well as higher risk of fungal and other opportunistic coinfections should be taken into account in patient treatment for a complicated coronavirus infection. A higher antibiotic resistance is induced by active indication-ignorant use of antibiotics, including pre-hospital treatment. A suitable treatment regimen in COVID-19 should avoid undue antibiotic prescriptions in every patient.

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ISSUES IN PROVIDING EMERGENCY MEDICAL ASSISTANCE TO SERVICEMEN WITH COMMUNITY-ACQUIRED PNEUMONIA IN THE ARCTIC ZONE OF RUSSIA

EMERGENCY MEDICAL CARE ◽

10.24884/2072-6716-2019-20-4-25-32 ◽

2019 ◽

Vol 20 (4) ◽

pp. 25-32

Author(s):

D. A. Arkhangelskiy ◽

Yu. N. Zakrevskij ◽

A. G. Shevchenko

Keyword(s):

Antibacterial Therapy ◽

Community Acquired Pneumonia ◽

The Arctic ◽

Arctic Zone ◽

Medical Assistance ◽

Factors Affecting ◽

Emergency Medical ◽

Emergency Medical Assistance

The article highlights the features of medical evacuations of servicemen with pneumonia in the Arctic zone; provides data on the time spent on medical evacuations of servicemen with community-acquired pneumonia from remote garrisons of the Arctic, as well as factors affecting this indicator. It is proposed to use the inventory for antibacterial therapy of complicated community-acquired pneumonia in case of impossibility of patient evacuation.

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Pharmaco-economic features of hospital treatment of acute community-acquired pneumonia in children

Bukovinian Medical Herald ◽

10.24061/2413-0737.xxv.3.99.2021.12 ◽

2021 ◽

Vol 25 (3 (99)) ◽

pp. 77-82

Author(s):

Y. Nechytailo ◽

N. Popelyuk ◽

O. Dolzhenko

Keyword(s):

Clinical Symptoms ◽

Community Acquired Pneumonia ◽

Point Of View ◽

Fourth Generation ◽

Hospital Treatment ◽

Cost Of Treatment ◽

Economic Point ◽

Corticosteroid Hormones ◽

Treatment Measures ◽

Pathogenetic Therapy

The goal. Тo analyze the features of treatment and medical expenses in children hospitalized for acute community-acquired pneumonia. Materials and methods. The study analyzed medical records and examined 51 children aged 2 to 17 months hospitalized for pneumonia. In patients studied clinical symptoms, severity, structure and duration of basic treatment measures, their cost. Results. The duration of inpatient treatment was 13.3±0.62 days with subsequent outpatient treatment and rehabilitation. Antibiotics, antipyretics, antihistamines, mucolytics and corticosteroid hormones were used in the treatment. The total cost of treatment for one case averaged 2346.9±145.7 hryvnias. The most expensive were the costs of antibiotics, and the cheapest - the antipyretics. Given the community-acquired nature of the process, the initial use of third- and fourth-generation cephalosporins was irrational and significantly increased the cost of treatment. Conclusions. The introduction of a new model of medicine focuses on the optimization of treatment tactics and the rational choice of antibiotics for acute community-acquired pneumonia. In antibacterial therapy is still inadequate, from a clinical and economic point of view, the choice of drugs. In the treatment of this disease, the role of pathogenetic therapy to restore the processes of mucociliary clearance and prevention of dysbiosis on the background of the use of antibiotics has increased.

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