RT Journal Article
SR Electronic
T1 Cost of hospitalised patients due to complicated urinary tract infections: a retrospective observational study in countries with high prevalence of multidrug-resistant Gram-negative bacteria: the COMBACTE-MAGNET, RESCUING study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e020251
DO 10.1136/bmjopen-2017-020251
VO 8
IS 4
A1 Laura Vallejo-Torres
A1 Miquel Pujol
A1 Evelyn Shaw
A1 Irith Wiegand
A1 Joan Miquel Vigo
A1 Margaret Stoddart
A1 Sally Grier
A1 Julie Gibbs
A1 Christiane Vank
A1 Nienke Cuperus
A1 Leo van den Heuvel
A1 Noa Eliakim-Raz
A1 Jordi Carratala
A1 Cuong Vuong
A1 Alasdair MacGowan
A1 Tanya Babich
A1 Leonard Leibovici
A1 Ibironke Addy
A1 Stephen Morris
A1 ,
YR 2018
UL http://bmjopen.bmj.com/content/8/4/e020251.abstract
AB Objective Complicated urinary tract infections (cUTIs) impose a high burden on healthcare systems and are a frequent cause of hospitalisation. The aims of this paper are to estimate the cost per episode of patients hospitalised due to cUTI and to explore the factors associated with cUTI-related healthcare costs in eight countries with high prevalence of multidrug resistance (MDR).Design This is a multinational observational, retrospective study. The mean cost per episode was computed by multiplying the volume of healthcare use for each patient by the unit cost of each item of care and summing across all components. Costs were measured from the hospital perspective. Patient-level regression analyses were used to identify the factors explaining variation in cUTI-related costs.Setting The study was conducted in 20 hospitals in eight countries with high prevalence of multidrug resistant Gram-negative bacteria (Bulgaria, Greece, Hungary, Israel, Italy, Romania, Spain and Turkey).Participants Data were obtained from 644 episodes of patients hospitalised due to cUTI.Results The mean cost per case was €5700, with considerable variation between countries (largest value €7740 in Turkey; lowest value €4028 in Israel), mainly due to differences in length of hospital stay. Factors associated with higher costs per patient were: type of admission, infection source, infection severity, the Charlson comorbidity index and presence of MDR.Conclusions The mean cost per hospitalised case of cUTI was substantial and varied significantly between countries. A better knowledge of the reasons for variations in length of stays could facilitate a better standardised quality of care for patients with cUTI and allow a more efficient allocation of healthcare resources. Urgent admissions, infections due to an indwelling urinary catheterisation, resulting in septic shock or severe sepsis, in patients with comorbidities and presenting MDR were related to a higher cost.