Cost of Hospitalizations due to Exacerbation in Patients with Non-Cystic Fibrosis Bronchiectasis.
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de la Rosa Carrillo David, Navarro Rolon Annie, Girón Moreno Rosa Maria, Montull Veiga Beatriz, Olveira Fuster Casilda, Padilla Galo Alicia, Prados Sánchez Concepción, Quintana Gallego Esther, Sibila Vidal Oriol, Celorrio Jiménez Nuria, Ruiz Peña Antonio, Torres Martí Antoni, Avilés Inglés Maria Jesús, Blanco Aparicio Marina, García-Clemente Marta, Golpe Gómez Rafael, Gómez Bonilla Ainhoa, Gómez González Cristina, Leal Arranz Maria Victoria, Mínguez Clemente Patricia, López Muñiz Belén, Máiz Carro Luis, Pando Sandoval Ana, Rodríguez Hermosa Juan Luis, Uranga Echeverria Ane, Núñez Ares Ana, López Roldán Lorena, Abellán Martínez Carmen, Martínez García Abel Jesús, Michel de la Rosa Francisco Javier, Godoy Mayoral Raúl, Martínez-García Miguel Ángel
Аннотация
OBJECTIVES: To find out the mean cost of hospitalizations due to exacerbations in bronchiectasis patients, and to identify factors associated with higher costs.
METHODS: Prospective, observational, multicenter study in adult bronchiectasis patients hospitalized due to exacerbation. All expenses from the patients' arrival at hospital to their discharge were calculated: diagnostic tests, treatments, transferals, home hospitalization, admission to convalescence centers, and hospitals' structural costs for each patient (each hospital's tariff for emergencies and 70% of the price of a bed for each day in a hospital ward).
RESULTS: A total of 222 patients (52.7% men, mean age 71.8 years) admitted to 29 hospitals were included. Adding together all the expenses, the mean cost of the hospitalization was EUR 5,284.7, most of which correspond to the hospital ward (86.9%), and particularly to the hospitals' structural costs. The adjusted multivariate analysis showed that chronic bronchial infection by Pseudomonas aeruginosa, days spent in the hospital, and completing the treatment with home hospitalization were factors independently associated with a higher overall cost of the hospitalization.
CONCLUSIONS: The mean cost of a hospitalization due to bronchiectasis exacerbation obtained from the individual data of each episode is higher than the cost per process calculated by the health authorities. The most determining factor of a higher cost is chronic bronchial infection due to P. aeruginosa, which leads to a longer hospital stay and the use of home hospitalization.