To Assess the Financial Impact of Multidrug Resistant Organisms in Adult Critically Ill Patients at A Tertiary Care Hospital
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Infections by antimicrobial-resistant organisms can result in failure of treatment, increased cost of medical treatment, increased hospitalization stay and increased socioeconomic burden, as per the World Health Organization (WHO) fact sheet. Antimicrobial resistance increases the burden in the intensive care unit (ICU) as measured by mortality, length of stay and hospitalization cost. Due to clinical and methodological heterogeneity, estimates about the attributable economic and clinical effects of infections due to multidrug resistant microorganisms remain unclear. Our study aimed at analyzing the cost of ICU treatment in patients who were infected with multidrug resistant organisms.(1) OBJECTIVES: To analyze the cost of Hospital stay and treatment in patients who developed infection with multidrug-resistant organisms in the intensive care unit. METHODOLOGY: Patients who were admitted to the ICU under the department of critical care medicine and developed infections with multidrug resistant organisms (MDRO)were selected as cases for the study. Controls were APACHE II matched patients who were admitted to the ICU under the department of critical care medicine who were not infected with MDRO infections. Acute Physiology And Chronic Health Evaluation (APACHE II) score and SOFA score were calculated at the time of admission. The participants were studied until discharge or death.(2,3) The cost under various billing heads (like pharmacy, laboratory investigations, antibiotic cost and cost of ICU and hospital stay) of all the participants in the study were analyzed. RESULTS: There was a higher cost of antibiotics in cases (median 177074/IQR 78973-250447) Indian rupees (INR) as compared to controls (median 10553/IQR 2395-21433) INR with a p value of 0.0000. The pharmacy cost was (mean 508273.7/SD 307440.3) INR in cases and (mean 125274.9/SD 80977.3) INR in controls with a p value of 0.0000. The laboratory cost was also significant with (mean 82701.8/SD 46986.17) INR in cases and (mean 31488.4/SD 12501.72) INR in controls with a p value of 0.0000. The cost of hospital stay was (mean 1004740/SD 604996.2) INR in cases and (mean 287938.8/SD 141478.9) INR in controls with a p value of 0.0000. The average per day cost of antibiotics was (median 7637.26/IQR 5765-8782.52) INR in cases and (median 845.5/IQR 335.71-2640.5) INR in controls with a p value of 0.0000. The average per day cost of pharmacy was (median 20452.40/IQR17907.89-23021.7) INR in cases and (median 11919.5/IQR 6941-17043.78) INR in controls with a p value of 0.0042. The average per day laboratory cost was (mean 3509.37/SD 1795.24) INR in cases and (mean 4141.85/SD 2631.67) INR in controls with a p value of 0.32. The average per day cost of hospital stay was (mean 39560.09/SD 11322.96) INR in cases and (mean 37272.8/SD 27105) INR in controls with a p value of 0.69. In patients with MDR infections the average length of hospital stay was 26.24 (SD 14.31) days and 9.28 (SD 5.65) days in patients without MDR infections with a p value of 0.0000.(4) The average length of ICU stay was 20.44 (SD 14.36) days in cases and 5.76 (SD 3.44) days in controls with a p value of 0.0000. The average ventilator days were 17.88 (SD 14.37) days in cases as against 5.72 (SD 3.33) days among the controls with a p value of 0.000. CONCLUSION: In this study the mean cost of hospital-stay, laboratory services, antibiotics and pharmacy were higher and statistically significant in patients who were infected with MDRO infections. The patients with MDRO infections also had significant higher length of hospital stay, ICU stay and days on ventilator which all amounted to the financial burden.
Language: English
Subfield: Applied Microbiology and Biotechnology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W4410920593