The attributable cost and length of hospital stay because of nosocomial pneumonia in intensive care units in 3 hospitals in Argentina: a prospective, matched analysis.
BACKGROUND
No information is available on the financial impact of nosocomial pneumonia in Argentina. To calculate the cost of nosocomial pneumonia in intensive care units, a 5-year, matched cohort study was undertaken at 3 hospitals in Argentina.


METHODS
Six adult intensive care units (ICU).


METHODS
Three hundred seven patients with nosocomial pneumonia (exposed) and 307 patients without nosocomial pneumonia (unexposed) were matched for hospital, ICU type, year admitted to study, length of stay more than 7 days, sex, age, antibiotic use, and average severity of illness score (ASIS). The patient's length of stay (LOS) in the ICU was obtained prospectively in daily rounds, the cost of a day was provided by the hospital's finance department, and the cost of antibiotics prescribed for nosocomial pneumonia was provided by the hospital's pharmacy department.


RESULTS
The mean extra LOS for 307 cases (compared with controls) was 8.95 days, the mean extra antibiotic defined daily doses (DDD) was 15, the mean extra antibiotic cost was $996, the mean extra total cost was $2255, and the extra mortality was 30.3%.


CONCLUSIONS
Nosocomial pneumonia results in significant patient morbidity and consumes considerable resources. In the present study, patients with nosocomial pneumonia had significant prolongation of hospitalization, cost, and a high extra mortality. The present study illustrates the potential cost savings of introducing interventions to reduce nosocomial pneumonia. To our knowledge, this is the first study evaluating this issue in Argentina.
Rosenthal
Victor D
VD
Department of Infectious Diseases and Hospital of Epidemiology, Bernal Medical Center, Buenos Aires, Argentina. victor_rosenthal@fibertel.com.ar
Guzman
Sandra
S
Migone
Oscar
O
Safdar
Nasia
N
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D001118:Argentina; D016022:Case-Control Studies; D003428:Cross Infection / Q000191:economics* / Q000401:mortality; D005260:Female; D017048:Health Care Costs; D006761:Hospitals; D006801:Humans; D007362:Intensive Care Units / Q000191:economics*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000191:economics* / Q000453:epidemiology; D011446:Prospective Studies; D012720:Severity of Illness Index
D000900:Anti-Bacterial Agents