Stavros Theologou
General Hospital of Athens, Greece
Title: Risk factors analysis of health care cost increase in ICU patients post cardiac surgery
Biography
Biography: Stavros Theologou
Abstract
Introduction: The hospitalization of post cardiac surgery ICU patients constitutes a complex mixture of procedures affected by a variety of clinical, administrational and technical aspects of care. The respective cost may drastically increase due to these patients’ increased clinical needs, including also the clinical state of delirium which is a quite common complication following this type of operation.
Methods: Τhe study included 179 consecutive patients who underwent open heart operation with cardiopulmonary bypass. The Confusion Assessment Method (CAM-ICU) was used for delirium diagnosis. Hospitalization outcomes were recorded by measuring certain intra - and post - operative procedure time intervals, along with the ICU and in-hospital length of stay as well.
Results:
A total of 179 patients post cardiac surgery were investigated, 129 of them were male and the rest 50 were female. The delirium complication was recorded in 20 out of 179 patients of the study (11.2%)
Bivariate analysis revealed that prolonged intraoperative time in cardiopulmonary bypass (p<0,001), prolonged sedation time (p=0,005) and prolonged length of stay with endotracheal tube (p<0,001) were significantly correlated with increased total health care cost.
Multivariate analysis showed that the level of complexity of the surgical operation (p<0,001), delirium complications (p<0,001) and the prolonged in-hospital length of stay (p<0,001), formulated altogether a group of factors for total health care cost increase.
Conclusions: A variety of factors seem to increase post cardiac surgery ICU patients’ total hospitalization cost and jeopardize quality of care and health outcomes. Resource management and monitoring, analytical process of health care costing in the Cardiac ICU and Ward, and recruitment of nursing staff with advanced
Key words:Health care cost increase, delirium complications, quality of care and health outcomes, hospitalization cost, in-hospital length of stay