KEYWORDS: economic impact, post-cardiosurgical, septic-purulent nosocomial infection.
BACKGROUND: It is imperative that specialists in preventive medicine study SPNI and its economic impact in an expeditious manner and provide this critical information to proper authorities.
GOALS: To determine the economic impact of morbidity through the post-cardiosurgical SPNI’s and development of cost-cutting recommendations.
METHODS: The study was performed by active detection of cases of post-cardiosurgical SPNI by the retrospective analysis method of the medical records of hospitalized patients in the Cardiac Surgery Department of Acquired Heart Defects of the Republican Clinical Hospital "Timofei Mosneaga" (RCH) during the period 2010-2013. The evaluation of the economic and social impact of the post-cardiosurgical SPNI was made by calculating the costs incurred by RCH, including treatment-related expenses, delivery orders of required medications, and medical articles for each patient. Expenses related to the patients’ hospital stay due to cardio-surgical SPNI and their inability to work, and deaths due to SPNI have been determined by calculating the financial losses incurred by the family and the society attributable to SPNI treatment. The financial impact of the death of the patients was calculated based on the estimated average salary, the age of the patient, life expectancy, and the per capita GDP in the Republic of Moldova in the years 2010 - 2013.
RESULTS: Approximately, a total of $2,253,700.00 was spent for the treatment of cardiosurgical patients between 2010 and 2013, of which $1,138,119.00 or 50.5% was spent on treatment of SPNI patients. An additional $256,832.00 was spent for patients with post-cardiosurgical SPNI that were hospitalized 10.47 days longer in comparison to patients without SPNI. For the treatment of patients with associated infections of SPNI, who were hospitalized for 15.36 days longer than patients without SPNI, an additional $111,067.00 was spent. A total of $367,900.00 or 16.3% of the total expenditure was incurred for the treatment of patients with a single infection of SPNI and associated infections. The total amount of additional costs related to hospital stay of patients with single infection of SPNI and associated infections, equals to $112,685.00 or 5.0% of the total expenditure. A total of 293 years was lost as a result of post-cardiosurgical SPNI deaths for 2010 - 2013, the economic loss amounts to $303,611.00. The loss of income for the families of deceased patients with post-cardiosurgical SPNI is $752,532.00. The full economic impact is $3,139,536.00, including 18.8% - ISPN maintenance and treatment costs, 33.7% - death related expenses for patients with SPNI, 47.5% - possible expenses related to emotional pain and suffering.
CONCLUSIONS: The economic impact of morbidity of post-cardiosurgical SPNI results in over expenditure of 1.4 times the annual budgets of Cardiac Surgery Departments.
Materials of the Conference “Contemporary Issues In Preventive Medicine”, funded by NIH USA, Fogarty International Center “iCREATE: Increasing Capacity in Research in Eastern Europe” grant number [2D43TW007261-11]
21-23 May, 2018, Yerevan, Republic of Armenia