Direct Medical Costs of Tetanus, Dengue, and Sepsis Patients in an Intensive Care Unit in Vietnam

Frontiers in Public Health

article

Trinh Manh Hung¹  Nguyen Van Hao²  Lam Minh Yen¹  Angela McBride¹  Vu Quoc Dat⁵  H. Rogier van Doorn¹  Huynh Thi Loan²  Nguyen Thanh Phong²  Martin J. Llewelyn⁴  Behzad Nadjm⁷  Sophie Yacoub¹  C. Louise Thwaites¹  Sayem Ahmed¹  Nguyen Van Vinh Chau²  Hugo C. Turner⁸ 

[1] Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme;Hospital for Tropical Diseases;Department of Infectious Diseases, University of Medicine and Pharmacy;Department of Global Health and Infection, Brighton and Sussex Medical School;Department of Infectious Diseases, Hanoi Medical University;Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford;Medical Research Council ,(MRC) Unit the Gambia at the London School of Hygiene & Tropical Medicine;MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London

关键词: dengue;    sepsis;    tetanus;    direct medical cost;    ICU;    Vietnam;   

DOI  :  10.3389/fpubh.2022.893200

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background Critically ill patients often require complex clinical care by highly trained staff within a specialized intensive care unit (ICU) with advanced equipment. There are currently limited data on the costs of critical care in low-and middle-income countries (LMICs). This study aims to investigate the direct-medical costs of key infectious disease (tetanus, sepsis, and dengue) patients admitted to ICU in a hospital in Ho Chi Minh City (HCMC), Vietnam, and explores how the costs and cost drivers can vary between the different diseases. Methods We calculated the direct medical costs for patients requiring critical care for tetanus, dengue and sepsis. Costing data (stratified into different cost categories) were extracted from the bills of patients hospitalized to the adult ICU with a dengue, sepsis and tetanus diagnosis that were enrolled in three studies conducted at the Hospital for Tropical Diseases in HCMC from January 2017 to December 2019. The costs were considered from the health sector perspective. The total sample size in this study was 342 patients. Results ICU care was associated with significant direct medical costs. For patients that did not require mechanical ventilation, the median total ICU cost per patient varied between US$64.40 and US$675 for the different diseases. The costs were higher for patients that required mechanical ventilation, with the median total ICU cost per patient for the different diseases varying between US$2,590 and US$4,250. The main cost drivers varied according to disease and associated severity. Conclusion This study demonstrates the notable cost of ICU care in Vietnam and in similar LMIC settings. Future studies are needed to further evaluate the costs and economic burden incurred by ICU patients. The data also highlight the importance of evaluating novel critical care interventions that could reduce the costs of ICU care.

【 授权许可】

CC BY