Costs and Outcomes of 1-year post-discharge care trajectories of patients admitted with infection due to antibiotic-resistant bacteria

Autor: Gregoire de Lagasnerie, M. Opatowski, C. Brun-Buisson, Mehdi Touat, Philippe Tuppin, Didier Guillemot, Laurence Watier, Jérôme Salomon
Přispěvatelé: Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Epidémiologie et modélisation de la résistance aux antimicrobiens - Epidemiology and modelling of bacterial escape to antimicrobials (EMAE), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Raymond Poincaré [AP-HP], Caisse Nationale d'Assurance Maladie des Travailleurs salariés (CNAMTS), Ministère de l'économie et des finances, We are grateful to DATAD of the Strategy, Studies and Statistics Directorate of the French National Health Insurance for providing the data., Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), HAL UVSQ, Équipe
Rok vydání: 2020
Předmět:
0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
Post discharge
030106 microbiology
Aftercare
Antimicrobial resistance
JEL: I - Health
Education
and Welfare/I.I1 - Health/I.I1.I18 - Government Policy • Regulation • Public Health
03 medical and health sciences
symbols.namesake
0302 clinical medicine
Antibiotic resistance
Ambulatory care
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Medicine
Humans
030212 general & internal medicine
Poisson regression
Hospital Costs
[SHS.ECO] Humanities and Social Sciences/Economics and Finance
National health
Administrative database
Bacteria
business.industry
Sequence analysis
Length of Stay
Rehabilitation care
[SHS.ECO]Humanities and Social Sciences/Economics and Finance
Patient Discharge
3. Good health
Anti-Bacterial Agents
Hospitalization
Data information
Infectious Diseases
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
Emergency medicine
symbols
[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Christian ministry
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
business
Zdroj: Journal of Infection
Journal of Infection, WB Saunders, 2021, 82 (3), pp.339-345. ⟨10.1016/j.jinf.2021.02.001⟩
Journal of Infection, 2021, 82 (3), pp.339-345. ⟨10.1016/j.jinf.2021.02.001⟩
ISSN: 1532-2742
0163-4453
DOI: 10.1016/j.jinf.2021.02.001⟩
Popis: International audience; Background: The impact of antibiotic resistance (AMR) on initial hospital management has been extensively studied but its consequences after hospital discharge remain largely unknown. We aimed to analyze hospital care trajectories, cumulative length of hospital stays (c-LOS) and associated costs of care over a 1-year period after hospitalization with incident AMR infection.Method: All incident bacterial infection-related hospitalizations occurring from January 1, 2015, to December 31, 2015 and recorded in the French national health data information system were extracted. Bacterial resistance ICD-10 codes determined six infection status. Inpatient and outpatient care consumption and associated costs were studied. The impact of resistance on c-LOS was estimated using a Poisson regression. A sequence analysis through optimal matching method was conducted to identify hospital trajectories along with an extrapolation.Finding: Of the 73,244 patients selected, 15.9% had AMR infection, thus providing 58,286 incident AMR infections after extrapolation. c-LOS was significantly longer for infections with resistant bacteria, reaching 20.4 days and 2.9 additional days IC95%[2.6; 3.2] for skin and soft tissue infections. An estimated 29,793 (51.1%) patients had hospital readmission within the following year, for a total cost of €675 million. Five post-discharge trajectories were identified: Post-hospitalization mainly at home (68.4% of patients); Transition to home from rehabilitation care (12.3%); Early death (
Databáze: OpenAIRE
Externí odkaz: