Direct medical costs of tetanus, dengue, and sepsis patients in an intensive care unit in Vietnam

Hung, T. M. et al. (2022) Direct medical costs of tetanus, dengue, and sepsis patients in an intensive care unit in Vietnam. Frontiers in Public Health, 10, 893200. (doi: 10.3389/fpubh.2022.893200) (PMID:35812512) (PMCID:PMC9263973)

Abstract

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.

• Item Type: Articles
• Additional Information: This study was supported by the Wellcome Trust VITAL project grant 217650/Z/19/Z. The primary studies from which the sample was taken from were supported by a Wellcome Trust fellowship (107367/Z/15/Z) to CT, a Wellcome Trust Ph.D. Fellowship award 203905/Z/16/Z to AM and funding from the OUCRU Wellcome Trust core grant 106680/B/14/Z. HCT acknowledges funding from the MRC Centre for Global Infectious Disease Analysis (reference MR/R015600/1), jointly funded by the UK Medical Research Council (MRC) and the UK Foreign, Commonwealth & Development Office (FCDO), under the MRC/FCDO Concordat agreement and is also part of the EDCTP2 programme supported by the European Union.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ahmed, Mr Syed
• Authors: Hung, T. M., Hao, N. V., Yen, L. M., McBride, A., Dat, V. Q., van Doorn, H. R., Loan, H. T., Phong, N. T., Llewelyn, M. J., Nadjm, B., Yacoub, S., Thwaites, C. L., Ahmed, S., Chau, N. V. V., and Turner, H. C.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Frontiers in Public Health
• Publisher: Frontiers Media
• ISSN: 2296-2565
• ISSN (Online): 2296-2565
• Copyright Holders: Copyright © 2022 Hung, Van Hao, Yen, McBride, Dat, van Doorn, Loan, Phong, Llewelyn, Nadjm, Yacoub, Thwaites, Ahmed, Van Vinh Chau, Turner and the Vietnam ICU Translational Applications Laboratory (VITAL) Investigators
• First Published: First published in Frontiers in Public Health 10: 893200
• Publisher Policy: Reproduced under a Creative Commons licence