COST-EFFECTIVENESS AND OUTCOMES OF DEVICE-INDUCED NEONATAL SEPSIS IN NICU

Document Type : Original Article

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Abstract

Introduction: Infants in neonatal intensive care units carry a high risk for nosocomial infections. The mortality rate of infections in this age group is reported as between 10-50%. In Egypt, there is deficiency of information and gap of knowledge on estimation of economic burden of device-associated infection in NICU. Minimizing device utilization rate and improving infection control measures could yield saving of costs, morbidity and mortality.
Aims: 1) To determine device associated infection rates with device utilization. 2) Estimate the direct and indirect costs of hospital stays for every case and for the total unit. 3) Determine morbidity and mortality of studied cases.
Patient and Method: This is a descriptive and analytical study done during the period from January 2013 to August 2015; included 140 patients admitted to NICU at El-Hussein University hospital with non-sepsis causes. They were selected by simple random method according to the inclusion and exclusion criteria, with full history, examination and investigations to every case. Divided into two groups, the first device utilization group included 100 cases, and the second non-device utilization group included 40 cases.
Results: Regarding the duration of hospital stay; there was a highly significant increase in first group, also there was a highly significant increase in the duration of hospital stay with multiple devices use. Regarding nosocomial infection; it was significantly higher in the first group, and much more in multiple device use. Regarding costs; the final cost was significantly higher in the first group (432.5 LE per-day), than the second group (352.9 LE per-day). Also the multiple device costs (533.6 LE per-day) was highly significant higher than single device cost (365.2 LE per-day). Total cost during the period of stay for a case in first group (15201.9 LE) was significantly higher than second group (6910.2 LE). About 70% of the first group improved, but morbidity rate was 8% and mortality rates reached 22%; while in the second group there was 95% cure with no mortality rates.
Conclusion:Less aggressive maneuvers and less device insertions mean better outcomes and little expenses in NICU.

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