Análise do custo das infecções hospitalares em unidades de terapia intensiva do Espírito Santo

Abstract

The infections got in the Intensive Care Units are high, generating repercussions on the expenses and mortality and in the state of Espírito Santo there are no available information about the economical impact of hospital infections in the Units. The study aims at estimating the costs of the three main infections in the Units intended for the treatment of adult patients in Espírito Santo State – urinary infections, pneumonias and bloody infections. It is a research of case control, with samples of 97 cases of hospital infection, notified, during the period of July 1, 2004 and December 31, 2005, by the Hospital Infection Control Commission of three public hospitals. The cases were classified by gender, age, number of diagnosis and gravity index APACHE IIA to the admission in the Units, with 97 controls which did not present any infection during the period. The analysis of infection direct costs in the Units, considered three variables: extra permanence in the Units, antimicrobial consume and the accomplishment of microbiological exams. When the cases were compared to the controls, it was observed that, the hospital additional permanence was around 18 days for the cases group, that consumed 2,4 more daily doses defined of antimicrobial and effectuated more 3,8 microbiological exams by patient, during the internment (p=0,000). In the total, the estimative of the average of hospital internment cost, in both groups (case and control), showed an extra cost of US$ 2.241, 35 (p=0, 05), having the Units daily rates as the most onerous factor. In the three cases of infection studied, the highest cost excess was noted in the pneumonia case, which was around US$ 2.801, 14 each patient. In conclusion, the infections got in the Units increased the permanence of patients and the antimicrobial consume in public hospitals in the state of Espírito Santo.