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Study on Extra-Cost Implications of Hospital Acquired Infection in Paediatric Patients in a Tertiary Hospital in Lagos, Nigeria
Abstract
Objectives: To assess excess duration of hospital stay, cost of laboratory tests and antibiotic therapy in consequence as well as deaths due to nosocomial infections (NI) in paediatric inpatients at the Lagos University Teaching Hospital, Nigeria.
Methods: Between 1994 and 1995, 4,981 admissions were prospectively studied for NI according to the CDC, NNIS criteria. A prospective cohort study of one-to-one matching of infected versus uninfected patients was used to estimate prolongation of hospital stay and added cost of management.
Results: There were 589 infected patients. Compared to the matched uninfected controls, the mean extra length of stay, in days, for patients with the indicated sites of infection was as follows: Blood-stream infection: 13.37, Surgical site infections: 11, Urinary tract infections: 9.92, Eye infections: 5.58; and other sites: 8.73.
Corresponding estimated average costs for the respective infection sites were each $119, $98, $88, $50 and $78. The total cost of laboratory tests in all infected patients was $7,785. The estimated total cost of antibiotic therapy was $15,515 in 310 infected patients versus $6,820 in 310 uninfected controls, difference $8,696 (P<0.00001). The Gross National product per capita in Nigeria during the study period was about $300 and the official exchange rate was N==22.50 to $1. Sixty-six infected patients (1.1%) died during hospitalization of whom most (0.8%) were related to a NI, particularly bloodstream infections.
Conclusion: Nosocomial infections constitute tremendous additional medical costs on health care service in children in Nigeria. In due cognizance, a review/prioritization of infection control measures and ensuring cost effective medical/laboratory facilities in hospitals will contain cost.
Key words: Nosocomial infections, cost, Paediatric patients.
[Nig. Jnl Health & Biomedical Sciences Vol.1(2) 2002: 59-67]
Methods: Between 1994 and 1995, 4,981 admissions were prospectively studied for NI according to the CDC, NNIS criteria. A prospective cohort study of one-to-one matching of infected versus uninfected patients was used to estimate prolongation of hospital stay and added cost of management.
Results: There were 589 infected patients. Compared to the matched uninfected controls, the mean extra length of stay, in days, for patients with the indicated sites of infection was as follows: Blood-stream infection: 13.37, Surgical site infections: 11, Urinary tract infections: 9.92, Eye infections: 5.58; and other sites: 8.73.
Corresponding estimated average costs for the respective infection sites were each $119, $98, $88, $50 and $78. The total cost of laboratory tests in all infected patients was $7,785. The estimated total cost of antibiotic therapy was $15,515 in 310 infected patients versus $6,820 in 310 uninfected controls, difference $8,696 (P<0.00001). The Gross National product per capita in Nigeria during the study period was about $300 and the official exchange rate was N==22.50 to $1. Sixty-six infected patients (1.1%) died during hospitalization of whom most (0.8%) were related to a NI, particularly bloodstream infections.
Conclusion: Nosocomial infections constitute tremendous additional medical costs on health care service in children in Nigeria. In due cognizance, a review/prioritization of infection control measures and ensuring cost effective medical/laboratory facilities in hospitals will contain cost.
Key words: Nosocomial infections, cost, Paediatric patients.
[Nig. Jnl Health & Biomedical Sciences Vol.1(2) 2002: 59-67]
