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Published in: Clinical Oral Investigations 5/2018

01-06-2018 | Original Article

Cost assessment of a new oral care program in the intensive care unit to prevent ventilator-associated pneumonia

Authors: Jérôme Ory, Charline Mourgues, Evelyne Raybaud, Russell Chabanne, Jean Christophe Jourdy, Fabien Belard, Renaud Guérin, Bernard Cosserant, Jean Sébastien Faure, Laure Calvet, Bruno Pereira, Dominique Guelon, Ousmane Traore, Laurent Gerbaud

Published in: Clinical Oral Investigations | Issue 5/2018

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Abstract

Objectives

Ventilator-associated pneumonia (VAP) is the most frequent hospital-acquired infections in intensive care units (ICU). In the bundle of care to prevent the VAP, the oral care is very important strategies, to decrease the oropharyngeal bacterial colonization and presence of causative bacteria of VAP. In view of the paucity of medical economics studies, our objective was to determine the cost of implementing this oral care program for preventing VAP.

Materials and methods

In five ICUs, during period 1, caregivers used a foam stick for oral care and, during period 2, a stick and tooth brushing with aspiration. Budgetary effect of the new program from the hospital’s point of view was analyzed for both periods. The costs avoided were calculated from the incidence density of VAP (cases per 1000 days of intubation). The cost study included device cost, benefit lost, and ICU cost (medication, employer and employee contributions, blood sample analysis…).

Results

A total of 2030 intubated patients admitted to the ICUs benefited from oral care. The cost of implementing the study protocol was estimated to be €11,500 per year. VAP rates decreased significantly between the two periods (p1 = 12.8% and p2 = 8.5%, p = 0.002). The VAP revenue was ranged from €28,000 to €45,000 and the average cost from €39,906 to €42,332. The total cost assessment calculated was thus around €1.9 million in favor of the new oral care program.

Conclusion and clinical relevance

Our study showed that the implementation of a simple strategy improved the quality of patient care is economically viable.

Trial registration

NCT02400294
Appendix
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Literature
1.
go back to reference World Health Organization, Department of Communicable Disease S and R (2012) Prevention of hospital-acquired infections: a practical Guide. 2nd Ed World Health Organization, Department of Communicable Disease S and R (2012) Prevention of hospital-acquired infections: a practical Guide. 2nd Ed
3.
go back to reference Safdar N, Crnich CJ, Maki DG (2005) The pathogenesis of ventilator-associated pneumonia: its relevance to developing effective strategies for prevention. Respir Care 50(6):725–741PubMed Safdar N, Crnich CJ, Maki DG (2005) The pathogenesis of ventilator-associated pneumonia: its relevance to developing effective strategies for prevention. Respir Care 50(6):725–741PubMed
6.
go back to reference Augustyn B (2007) Ventilator-associated pneumonia: risk factors and prevention. Crit Care Nurse 27(4):32–39PubMed Augustyn B (2007) Ventilator-associated pneumonia: risk factors and prevention. Crit Care Nurse 27(4):32–39PubMed
9.
go back to reference Vegas AA, Jodra VM, García ML (1993) Nosocomial infection in surgery wards: a controlled study of increased duration of hospital stays and direct cost of hospitalization. Eur J Epidemiol 9(5):504–510PubMed Vegas AA, Jodra VM, García ML (1993) Nosocomial infection in surgery wards: a controlled study of increased duration of hospital stays and direct cost of hospitalization. Eur J Epidemiol 9(5):504–510PubMed
11.
go back to reference Obtel M, Soulami OB, Motawakkil S, Netjari C (2011) Cost of healthcare associated infections owing to the increased length of hospital stay in the intensive care unit at the Casablanca teaching hospital (Morocco). Hygienes 19(5):310–313 Obtel M, Soulami OB, Motawakkil S, Netjari C (2011) Cost of healthcare associated infections owing to the increased length of hospital stay in the intensive care unit at the Casablanca teaching hospital (Morocco). Hygienes 19(5):310–313
12.
go back to reference Or Z, Renaud T (2009) Principes et enjeux de la tarification à l’activité à ‘hopital (T2A) - Enseignements de la theorie economique et des experiences etrangeres Or Z, Renaud T (2009) Principes et enjeux de la tarification à l’activité à ‘hopital (T2A) - Enseignements de la theorie economique et des experiences etrangeres
Metadata
Title
Cost assessment of a new oral care program in the intensive care unit to prevent ventilator-associated pneumonia
Authors
Jérôme Ory
Charline Mourgues
Evelyne Raybaud
Russell Chabanne
Jean Christophe Jourdy
Fabien Belard
Renaud Guérin
Bernard Cosserant
Jean Sébastien Faure
Laure Calvet
Bruno Pereira
Dominique Guelon
Ousmane Traore
Laurent Gerbaud
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 5/2018
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-017-2289-6

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