scholarly journals Internações, óbitos e custos hospitalares pelas intercorrências dialíticas

2019 ◽  
Vol 13 ◽  
Author(s):  
Edison Vitório de Souza Júnior ◽  
Sarah Rodrigues Silva ◽  
Poliana Souza Lapa ◽  
Mariana Alves Soledade de Jesus ◽  
Michele Silva dos Santos ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Kidney Diseases ◽  
Average Length ◽  
Hospital Costs ◽  
Renal Dialysis ◽  
The Public ◽  
Average Value ◽  
Average Length Of Stay ◽  
Quantitative Descriptive ◽  
Dialysis Complications

Objetivo: descrever as internações, óbitos e custos hospitalares pelas intercorrências dialíticas em pacientes renais crônicos no Nordeste. Método: trata-se de um estudo quantitativo, descritivo e ecológico, voltado para a análise de dados do Sistema de Informações Hospitalares, organizados em frequências absolutas e relativas, a partir de tabelas construídas no software Excel. Resultados: notificaram-se 14.052 internações e 987 óbitos no Nordeste. Gerou-se, como consequência, um custo superior a R$ 19,6 milhões aos cofres públicos, com um valor médio de internação de R$ 1.543,09 e uma média de permanência de 9,1 dias. Destacaram-se os Estados de Alagoas, com a prevalência das internações (38,2%), e Bahia, em relação aos óbitos (40%), custos hospitalares (61,4%), média de permanência (14,4 dias) e valor médio de internação (R$ 2.794,42). Conclusão: aponta-se que as internações e óbitos pelas intercorrências dialíticas constituem um importante problema na Nefrologia, causando prejuízos diretos aos recursos financeiros públicos, especialmente, nos Estados da Bahia e Alagoas, por evidenciarem a maioria dos casos. Descritores: Saúde Pública; Nefrologia; Nefropatias; Diálise Peritoneal; Diálise Renal; Custos de Cuidados de Saúde.Abstract Objective: to describe hospitalizations, deaths and hospital costs due to dialysis complications in chronic renal patients in the Northeast. Method: this is a quantitative, descriptive and ecological study, focused on the analysis of data from the Hospital Information System, organized in absolute and relative frequencies, using tables built using Excel software. Results: 14,052 hospitalizations and 987 deaths were reported in the Northeast. As a result, the public coffers cost over R $ 19.6 million, with an average hospitalization value of R $ 1,543.09 and an average length of stay of 9.1 days. The states of Alagoas stood out, with the prevalence of hospitalizations (38.2%), and Bahia, in relation to deaths (40%), hospital costs (61.4%), average length of stay (14.4 days) and average value of hospitalization (R $ 2,794.42). Conclusion: it is pointed out that hospitalizations and deaths due to dialysis complications are an important problem in Nephrology, causing direct damage to public financial resources, especially in the states of Bahia and Alagoas, as they show the majority of cases. Descriptors:  Public Health; Nephrology; Kidney Diseases; Peritoneal Dialysis; Renal Dialysis; Health Care Costs. Resumen Objetivo: describir las hospitalizaciones, muertes y costos hospitalarios por las intercurrencias dialíticas en pacientes renales crónicos en el noreste. Método: se trata de un estudio cuantitativo, descriptivo y ecológico, destinado a analizar los datos del Sistema de Informaciones del Hospital, organizado en frecuencias absolutas y relativas, a partir de tablas construidas en el software Excel. Resultados: se reportaron 14.052 hospitalizaciones y 987 muertes en el noreste. Se generó como resultado de eso, un costo en exceso de R $ 19,6 millones para el gobierno, una hospitalización con costo promedio de R$1,543.09 y una estadía promedio de 9.1 días. Entre los estados, Alagoas tuvo una mayor prevalencia de hospitalizaciones (38,2%) y Bahía en las muertes (40%), costos hospitalarios (61,4%), duración media de la estancia (14,4 días) y media hospitalización (R $ 2.794,42). Conclusión: se observa que las hospitalizaciones y muertes debidas a las intercurrencias dialíticas se constituyen un problema importante en la nefrología, lo que implica directamente en los cofres públicos, especialmente en los Estados de Bahía y Alagoas, como evidencia de una mayor prevalencia de casos. Descriptores: Salud Pública; Nefrología; Enfermedades Renales; Diálisis Peritoneal; Diálisis Renal; Costos de la Atención en Salud. Descriptores: Salud Pública; Nefrología; Enfermedades Renales; Diálisis Peritoneal; Diálisis Renal; Costos de la Atención en Salud.  

scholarly journals Internações, óbitos e custos hospitalares por diabetes mellitus

2019 ◽  
Vol 13 ◽  
Author(s):  
Edison Vitório de Souza Júnior ◽  
Mariana Alves Soledade de Jesus ◽  
Poliana Souza Lapa ◽  
Jamille Sales da Cruz ◽  
Tayná Freitas Maia ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Length Of Stay ◽  
Public Hospital ◽  
Average Length ◽  
Hospital Costs ◽  
Northeastern Brazil ◽  
Slight Reduction ◽  
The Public ◽  
Average Length Of Stay ◽  
Public Health Epidemiology

Objetivo: descrever as internações, óbitos e custos públicos hospitalares por Diabetes Mellitus no Nordeste brasileiro entre 2013 e 2017. Método: trata-se de estudo quantitativo, descritivo e ecológico com levantamento de dados secundários do Sistema de Informações Hospitalares. Coletaram-se os dados referentes às internações, óbitos, custos hospitalares, valor médio de internação e média de permanência. Analisaram-se os dados mediante estatística descritiva simples, apresentando-os por meio de tabelas elaboradas no software Excel. Resultados: registraram-se 136.504 internações e 7.424 óbitos por Diabetes Mellitus no Nordeste brasileiro. Destacaram-se, além disso, os custos públicos hospitalares superiores a R$ 65 milhões, com valor médio de internação de R$ 545,08 e média de permanência de 5,4 dias. Conclusão: conclui-se que as internações, óbitos e os custos públicos hospitalares por Diabetes Mellitus apresentaram discreta redução e, mesmo assim, implicaram, de maneira expressiva, o orçamento público, além das repercussões pessoais e familiares impostas pela doença. Descritores: Saúde Pública; Epidemiologia; Endocrinologia; Custos de Cuidados de Saúde; Doenças do Sistema Endócrino; Indicadores Básicos de Saúde.Abstract Objective: to describe hospitalizations, deaths and public hospital costs for Diabetes Mellitus in Northeastern Brazil between 2013 and 2017. Method: this is a quantitative, descriptive and ecological study with secondary data collection from the Hospital Information System. Data was collected regarding hospitalizations, deaths, hospital costs, average hospitalization value and average length of stay. Data was analyzed using simple descriptive statistics, presenting them using tables prepared using Excel software. Results: 136,504 hospitalizations and 7,424 deaths from diabetes mellitus were recorded in the Brazilian Northeast. Also noteworthy were the public hospital costs over R$ 65 million, with an average hospitalization value of R$ 545.08 and an average length of stay of 5.4 days. Conclusion: it can be concluded that hospitalizations, deaths and public hospital costs for Diabetes Mellitus showed a slight reduction and, even so, they significantly implied the public budget, in addition to the personal and family repercussions imposed by the disease. Descriptors: Public Health; Epidemiology; Endocrinology; Health Care Costs;ResumenObjetivo: describir las hospitalizaciones, muertes y costos hospitalarios por diabetes mellitus en el noreste de Brasil, entre 2013 y 2017. Método: se trata de un estudio cuantitativo, descriptivo y ecológico, con la recopilación de datos secundarios del Sistema de Informaciones Hospitalarias. Se recopilaron los datos de hospitalizaciones, muertes, costos hospitalarios, valor promedio y tiempo de permanencia de la hospitalización. Los datos se analizaron mediante estadísticas descriptivas simples y se presentaron a través de tablas elaboradas en el software Excel. Resultados: se registraron 136,504 hospitalizaciones y 7,424 muertes por diabetes mellitus en el noreste de Brasil. Además, se destacaron los costos hospitalarios públicos superiores a R $ 65 millones, con un valor promedio de hospitalización de R$ 545.08 y una permanencia con promedio de 5,4 días. Conclusión: se concluye que las hospitalizaciones, las muertes y los costos hospitalarios debidos a la diabetes mellitus presentaron una ligera reducción, y aun así, estaban significativamente implicados en el presupuesto público, además de las repercusiones personales y familiares impuestas por la enfermedad. Descriptores: Salud Pública; Epidemiología; Endocrinología; Costos de la Atención en Salud; Enfermedades del Sistema Endocrino; Indicadores de Salud.

scholarly journals Penerapan Clinical Pathways sebagai Instrumen Pengendalian Biaya Pelayanan : Studi Penelitian Tindakan Penderita BPJS yang Menjalani Operasi Caesar dengan Sistem Pembayaran INA-CBG

2021 ◽  
Vol 4 (2) ◽  
pp. 593-599
Author(s):  
Annisa Fitria ◽  
Andri Sofa Armani ◽  
Thinni Nurul Rochmah ◽  
Bangun Trapsila Purwaka ◽  
Widodo Jatim Pudjirahardjo
Keyword(s):  
Action Research ◽  
Caesarean Section ◽  
Length Of Stay ◽  
Cesarean Section ◽  
Clinical Pathway ◽  
Average Length ◽  
Clinical Pathways ◽  
Hospital Costs ◽  
Average Length Of Stay ◽  
Length Of Hospitalization

This study aims to determine the effect of using clinical pathways to control total actual hospital costs for BPJS patients who undergo a cesarean section. The method used in this research is action research. The results showed that the average actual hospital costs were significantly higher after the application of CP with p = 0.019. The average length of stay, service costs, and hospital costs were significantly lower in the entire CP form group with p = 0.012, p = 0.013, and p = 0.012. In conclusion, this study shows that the application of clinical pathways can reduce the length of hospitalization and actual hospital costs for cesarean section patients and indicates that clinical pathways can make services more efficient.   Keywords: Hospital Costs, Clinical Pathway, Caesarean Section

scholarly journals Epidemiological overview of epilepsy by Brazilian macro-regions

2021 ◽  
Author(s):  
Natália Guerreiro Costa Neeser ◽  
Caio Lopes Pereira Santos ◽  
Gabriela Malta Coutinho ◽  
Rebeca Menezes de Oliveira Lima ◽  
Tauá Vieira Bahia
Keyword(s):  
Mortality Rate ◽  
Length Of Stay ◽  
Average Length ◽  
Secondary Data ◽  
Public System ◽  
The Public ◽  
Average Length Of Stay ◽  
The North ◽  
Epidemiological Profile ◽  
Absolute Population

Introdution: Studying the epidemiology of epilepsy is important for the knowledge of this disease in the national territory, and also to improve the Public System. Objectives: Describe the epidemiological profile of epilepsy in Brazilian regions between 2010 and 2019. Methods: Refers to an ecological study with secondary data from the Ministry of Health, through DATASUS. The period investigated was from January 2010 to December 2019, in Brazilian regions. The variables explored were region, sex, number of hospitalizations, average length of stay and mortality rate. Results: 507,443 hospitalizations were identified, with the highest numbers of cases being in the Southeast (44.34%) and the lowest in the North (5.43%). There was a predominance of hospitalizations in males (58%).The mortality rate varied between 2.97 (Northeast) and 1.44 (South). Southeast had the longest stay (6.8 days) and the shortest was in the South (4.4 days). Conclusions: After analyzing this study, males have the highest rate of hospitalization and the Southeast has the highest number of hospitalizations and average length of stay for epilepsy, which may be associated with the fact that this region has the largest absolute population. Although, the Northeast had the highest mortality rate, a situation possibly related to a lower integration of the health system compared to the other regions.

scholarly journals Length of stay comparisons for private and public hospitals

2000 ◽  
Vol 23 (3) ◽  
pp. 162 ◽  
Author(s):  
Jennifer Badham ◽  
Jason Brandrup
Keyword(s):  
Length Of Stay ◽  
Public Hospital ◽  
Average Length ◽  
Public Hospitals ◽  
Private Hospitals ◽  
The Public ◽  
Average Length Of Stay ◽  
Private And Public

This analysis uses average length of stay as a proxy for efficiency, to compare the Australian private and public hospitalsectors. We conclude that private hospitals are more efficient than public hospitals in providing the range of care providedby private hospitals. However, public hospitals are more efficient in handling the casemix of the public hospital sector.The picture is more complicated when particular types of care (such as obstetric and psychiatric) are excluded.

Hospital Costs of Nosocomial Infections: A Prospective Three-Month Study In a Community Hospital

1980 ◽  
Vol 1 (3) ◽  
pp. 150-152 ◽  
Author(s):  
William E. Scheckler
Keyword(s):  
Length Of Stay ◽  
Nosocomial Infections ◽  
Community Hospital ◽  
Average Length ◽  
Hospital Costs ◽  
Hospital Charges ◽  
Average Hospital ◽  
Average Length Of Stay ◽  
Therapeutic Services ◽  
Tract Infections

AbstractA prospective three-month study of the hospital costs associated with nosocomial infections was done in a 390-bed, 30-bassinet community-teaching hospital early in 1978. All hospital charges for diagnostic and therapeutic services required by nosocomial infections, and added length of stay due to the infections, were recorded. During the study period 123 infections occurred in 104 patients (a 2.7% incidence, considering the 4,485 patients discharged during this time). The average length of stay was prolonged 3.0 days for all nosocomial infections; this accounted for about half of the $636 average hospital charges for each nosocomial infection. The 65 nosocomial urinary tract infections prolonged the length of stay an average of 0.6 days and the total hospital charges were $146 for each infection, leading us to believe that the proportion of nosocomial infections at any given site may greatly alter the “average” cost of nosocomial infections. Our data from a community hospital show a shorter prolongation of length of stay and lower hospital costs when compared with the few other studies in the literature.

scholarly journals Colonization and Infection With MRSA and CRKP and Its Result in an Increased Mortality Rate Within the Intensive Care and High-Dependency Units in Barbados

2020 ◽  
Vol 41 (S1) ◽  
pp. s173-s174
Author(s):  
Keisha Gustave
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
High Mortality ◽  
Average Length ◽  
Cohort Analysis ◽  
Health Concern ◽  
Queen Elizabeth Hospital ◽  
Surveillance Program ◽  
Average Length Of Stay ◽  
High Dependency

Background: Methicillin-resistant Staphylococcus aureus(MRSA) and carbapenem-resistant Klebsiella pneumoniae (CRKP) are a growing public health concern in Barbados. Intensive care and critically ill patients are at a higher risk for MRSA and CRKP colonization and infection. MRSA and CRKP colonization and infection are associated with a high mortality and morbidly rate in the intensive care units (ICUs) and high-dependency units (HDUs). There is no concrete evidence in the literature regarding MRSA and CRKP colonization and infection in Barbados or the Caribbean. Objectives: We investigated the prevalence of MRSA and CRKP colonization and infection in the patients of the ICU and HDU units at the Queen Elizabeth Hospital from 2013 to 2017. Methods: We conducted a retrospective cohort analysis of patients admitted to the MICU, SICU, and HDU from January 2013 through December 2017. Data were collected as part of the surveillance program instituted by the IPC department. Admissions and weekly swabs for rectal, nasal, groin, and axilla were performed to screen for colonization with MRSA and CRKP. Follow-up was performed for positive cultures from sterile isolates, indicating infection. Positive MRSA and CRKP colonization or infection were identified, and patient notes were collected. Our exclusion criteria included patients with a of stay of <48 hours and patients with MRSA or CRKP before admission. Results: Of 3,641 of persons admitted 2,801 cases fit the study criteria. Overall, 161 (5.3%) were colonized or infected with MRSA alone, 215 (7.67%) were colonized or infected with CRKP alone, and 15 (0.53%) were colonized or infected with both MRSA and CRKP. In addition, 10 (66.6%) of patients colonized or infected with MRSA and CRKP died. Average length of stay of patients who died was 50 days. Conclusions: The results of this study demonstrate that MRSA and CRKP cocolonization and coinfection is associated with high mortality in patients within the ICU and HDU units. Patients admitted to the ICU and HDU with an average length of stay of 50 days are at a higher risk for cocolonization and coinfection with MRSA and CRKP. Stronger IPC measures must be implemented to reduce the spread and occurrence of MRSA and CRKP.Funding: NoneDisclosures: None

scholarly journals Temporal Changes in Central-Line–Associated Bloodstream Infection Time Between Events, 2017–2018 Versus 2015–2016

2020 ◽  
Vol 41 (S1) ◽  
pp. s403-s404
Author(s):  
Jonathan Edwards ◽  
Katherine Allen-Bridson ◽  
Daniel Pollock
Keyword(s):  
Length Of Stay ◽  
Patient Care ◽  
Average Length ◽  
Bloodstream Infections ◽  
Central Line ◽  
Significant Shift ◽  
Care Hospital ◽  
Average Length Of Stay ◽  
Period 2 ◽  
Hospital Bed

Background: The CDC NHSN surveillance coverage includes central-line–associated bloodstream infections (CLABSIs) in acute-care hospital intensive care units (ICUs) and select patient-care wards across all 50 states. This surveillance enables the use of CLABSI data to measure time between events (TBE) as a potential metric to complement traditional incidence measures such as the standardized infection ratio and prevention progress. Methods: The TBEs were calculated using 37,705 CLABSI events reported to the NHSN during 2015–2018 from medical, medical-surgical, and surgical ICUs as well as patient-care wards. The CLABSI TBE data were combined into 2 separate pairs of consecutive years of data for comparison, namely, 2015–2016 (period 1) and 2017–2018 (period 2). To reduce the length bias, CLABSI TBEs were truncated for period 2 at the maximum for period 1; thereby, 1,292 CLABSI events were excluded. The medians of the CLABSI TBE distributions were compared over the 2 periods for each patient care location. Quantile regression models stratified by location were used to account for factors independently associated with CLABSI TBE, such as hospital bed size and average length of stay, and were used to measure the adjusted shift in median CLABSI TBE. Results: The unadjusted median CLABSI TBE shifted significantly from period 1 to period 2 for the patient care locations studied. The shift ranged from 20 to 75.5 days, all with 95% CIs ranging from 10.2 to 32.8, respectively, and P < .0001 (Fig. 1). Accounting for independent associations of CLABSI TBE with hospital bed size and average length of stay, the adjusted shift in median CLABSI TBE remained significant for each patient care location that was reduced by ∼15% (Table 1). Conclusions: Differences in the unadjusted median CLABSI TBE between period 1 and period 2 for all patient care locations demonstrate the feasibility of using TBE for setting benchmarks and tracking prevention progress. Furthermore, after adjusting for hospital bed size and average length of stay, a significant shift in the median CLABSI TBE persisted among all patient care locations, indicating that differences in patient populations alone likely do not account for differences in TBE. These findings regarding CLABSI TBEs warrant further exploration of potential shifts at additional quantiles, which would provide additional evidence that TBE is a metric that can be used for setting benchmarks and can serve as a signal of CLABSI prevention progress.Funding: NoneDisclosures: None

scholarly journals Biased and unbiased estimation of the average length of stay in intensive care units in the Covid-19 pandemic

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Nathanael Lapidus ◽  
Xianlong Zhou ◽  
Fabrice Carrat ◽  
Bruno Riou ◽  
Yan Zhao ◽  
...  
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Average Length ◽  
Parametric Method ◽  
Estimation Methods ◽  
Unbiased Estimation ◽  
Bed Occupancy ◽  
Average Length Of Stay ◽  
Discharged Patients ◽  
First Admission

Abstract Background The average length of stay (LOS) in the intensive care unit (ICU_ALOS) is a helpful parameter summarizing critical bed occupancy. During the outbreak of a novel virus, estimating early a reliable ICU_ALOS estimate of infected patients is critical to accurately parameterize models examining mitigation and preparedness scenarios. Methods Two estimation methods of ICU_ALOS were compared: the average LOS of already discharged patients at the date of estimation (DPE), and a standard parametric method used for analyzing time-to-event data which fits a given distribution to observed data and includes the censored stays of patients still treated in the ICU at the date of estimation (CPE). Methods were compared on a series of all COVID-19 consecutive cases (n = 59) admitted in an ICU devoted to such patients. At the last follow-up date, 99 days after the first admission, all patients but one had been discharged. A simulation study investigated the generalizability of the methods' patterns. CPE and DPE estimates were also compared to COVID-19 estimates reported to date. Results LOS ≥ 30 days concerned 14 out of the 59 patients (24%), including 8 of the 21 deaths observed. Two months after the first admission, 38 (64%) patients had been discharged, with corresponding DPE and CPE estimates of ICU_ALOS (95% CI) at 13.0 days (10.4–15.6) and 23.1 days (18.1–29.7), respectively. Series' true ICU_ALOS was greater than 21 days, well above reported estimates to date. Conclusions Discharges of short stays are more likely observed earlier during the course of an outbreak. Cautious unbiased ICU_ALOS estimates suggest parameterizing a higher burden of ICU bed occupancy than that adopted to date in COVID-19 forecasting models. Funding Support by the National Natural Science Foundation of China (81900097 to Dr. Zhou) and the Emergency Response Project of Hubei Science and Technology Department (2020FCA023 to Pr. Zhao).

scholarly journals Times of change in complex environments - Evaluating hospital co-payments in Palestine refugee camps

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S V Valente de Almeida ◽  
H Ghattas ◽  
G Paolucci ◽  
A Seita
Keyword(s):  
Length Of Stay ◽  
Policy Change ◽  
Negative Binomial ◽  
Negative Impact ◽  
Average Length ◽  
Lessons Learned ◽  
Policy Impact ◽  
Average Length Of Stay ◽  
Ex Post ◽  
The Impact

Abstract We measure the impact introducing a of 10% co-payment component on hospitalisation costs for Palestine refugees from Lebanon in public and private hospitals. This ex-post analysis provides a detailed insight on the direction and magnitude of the policy impact in terms of demand and supply for healthcare. The data was collected by the United Nations Relief and Works Agency for Palestine Refugees in the Near East and include episode level information from all public, private and Red Crescent Hospitals in Lebanon, between April 2016 and October 2017. This is a complete population episode level dataset with information from before and after the policy change. We use multinomial logit, negative binomial and linear models to estimate the policy impact on demand by type of hospital, average length of stay and treatment costs for the patient and the provider. After the new policy was implemented patients were 18% more likely to choose a (free-of-charge) PRCS hospital for secondary care, instead of a Private or Public hospital, where the co-payment was introduced. This impact was stronger for episodes with longer stays, which are also the more severe and more expensive cases. Average length of stay decreased in general for all hospitals and we could not find a statistically significant impact on costs for the provider nor the patient. We find evidence that the introduction of co-payments is hospital costs led to a shift in demand, but it is not clear to what extent the hospitals receiving this demand shift were prepared for having more patients than before, also because these are typically of less quality then the others. Regarding costs, there is no evidence that the provider managed to contain costs with the new policy, as the demand adapted to the changes. Our findings provide important information on hospitalisation expenses and the consequences of a policy change from a lessons learned perspective that should be taken into account for future policy decision making. Key messages We show that in a context of poverty, the introduction of payment for specific hospital types can be efficient for shifting demand, but has doubtable impact on costs containment for the provider. The co-payment policy can have a negative impact on patients' health since after its implementation demand increased at free-of-charge hospitals, which typically have less resources to treat patients.

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