3 research outputs found
Bilan Ă©conomique du fonctionnement de plusieurs unitĂ©s de cohorting dĂ©diĂ©es aux patients porteurs dâune bactĂ©rie hautement rĂ©sistante aux antibiotiques Ă©mergente (BHRe) aux HĂŽpitaux universitaires de Strasbourg
MĂ©decine. SantĂ© publiqueLes mesures classiques de gestion dâune Ă©pidĂ©mie de colonisations Ă bactĂ©ries hautement rĂ©sistantes aux antibiotiques Ă©mergentes (BHRe) ne sont pas toujours suffisantes et impliquent le recours Ă une unitĂ© de cohorting. Les objectifs de cette Ă©tude Ă©taient dâĂ©valuer le coĂ»t relatif au fonctionnement dâune unitĂ© de cohorting en mĂ©decine et en SSR. Une Ă©tude de coĂ»ts rĂ©trospective utilisant une approche en coĂ»ts complets identifiant chaque type de dĂ©pense a Ă©tĂ© menĂ©e sur chacune de ces unitĂ©s pendant leur pĂ©riode dâouverture. En mĂ©decine, le bilan Ă©conomique objective un dĂ©ficit majoritairement liĂ© Ă une baisse des recettes secondaire Ă une diminution du nombre de sĂ©jours et Ă un allongement de la durĂ©e moyenne de sĂ©jour. Une optimisation du taux dâoccupation de ces lits ainsi quâune fluidification des sorties de cette unitĂ©, amĂ©liorent ce bilan. En SSR, dont les modalitĂ©s de financement dĂ©pendent en faible proportion de lâactivitĂ©, ce bilan est Ă lâĂ©quilibre. MalgrĂ© leur coĂ»t important, les unitĂ©s de cohorting permettent la maĂźtrise dâune Ă©pidĂ©mie de BHRe. Une Ă©tude mĂ©dico-Ă©conomique prenant en compte Ă©galement les coĂ»ts Ă©vitĂ©s par ces dispositifs, serait intĂ©ressante Ă mettre en place. La mise en place dâune filiĂšre de soins dĂ©diĂ©e aux patients BHRe, quoiquâimpopulaire, pourrait ĂȘtre une solution coĂ»t efficace en termes de risque Ă©pidĂ©mique.Traditional measures for managing an outbreak of Highly Drug Resistant Organisms (HDRO) colonizations are not always sufficient and involve the use of an isolation unit. The outcome of the present study was to determine the relative cost structure of this protocol in a medical unit and in a geriatric reeducation unit. A retrospective cost analysis, using a complete costs approach and identifying each type of expenditure, has been conducted for each of these units during their operational period. We see that in the medical unit, the economic balance sheet reveals a deficit due to a decrease in revenues. This decrease is caused by a fewer number of patient-stays and an increase in the length of the patientâs entire hospital stay. Optimization of the occupancy rate as well as a fluidization of the exits of this unit may improve this balance. In the reeducation unit, in which the financial model is less dependent on the unitâs activity, the economic balance sheet reaches breakeven point. Despite their relative higher cost, isolation units are an efficient tool to manage a HDRO outbreak. In the future, a full medico-economic study examining the potential cost savings related to isolation units may warrant further investigation. The establishment of a care network dedicated to HDRO patients, although unpopular, could possibly be a cost effective solution in terms of epidemic risk.ble patientâs survival. Finally, further efforts are needed to better integrate the Galsky definition in routine practice