Hospital protocol for the early detection and treatment of severe sepsis

Estimate of the economic impact of implementing an in hospital protocol for the early detection and treatment of severe sepsis in public and private hospitals in southern Brazil

Alvaro Koenig1 ,

Paulo Dorneles Picon2 ,

Janaína Feijó3 ,

Eliezer Silva4 ,

Glauco Adrieno Westphal5

Rev Bras Ter Intensiva. 2010; 22(3):213-219

ABSTRACT

Objective: To analyze the economic impact of an early sepsis detection protocol in two general hospitals.

Methods: We analyzed data collected from a prospective study of septic patients before and after the implementation of a protocol for early diagnosis of severe sepsis. We conducted a costeffectiveness analysis comparing: mortality rate, cost of sepsis treatment and indirect costs attributed to years of productive life lost to premature death in both phases.

Results: Two hundred seventeen patients were included, 102 in phase I and 115 in phase II. After protocol implementation, in private and public hospital, mortality rates decreased from 50% to 32.2% and from 67.6% to 41% (p < 0.05). The mean years of productive life lost due to sepsis decreased from 3.18 to 0.80 and 9.81 to 4.65 (p < 0.05), with a mean gain of 2.38 and 5.16 years of productive life, for each septic patient. Considering Brazilian gross domestic product per capita, estimated productivity loss due to sepsis decreased between 3.2 and 9.7 billion US dollars, varying based on the incidence of sepsis. Hospital costs were similar in both phases.

Conclusion: A protocol for early detection and treatment of in-hospital septic patients is highly cost-effective from a societal perspective.

1. Master, Professor at Universidade da Região de Joinville – Univille; Phycisian from Comissão de Controle Hospitalar of Centro Hospitalar Unimed - Joinville (SC), Brazil.

2. PhD, Physician of Clinical Research Unit of Hospital das Clinicas de Porto Alegre - HCPA – Porto Alegre (RS), Brazil.

3. Physician from Hospital Municipal São José - Joinville (SC), Brazil.

4. Full Professor, Physician from Hospital Israelita Albert Einstein - HIAE, São Paulo (SP), Brazil.

5. PhD, Professor at Universidade da Região de Joinville – Univille; Physician from Centro Hospitalar Unimed and from Hospital Municipal São José - Joinville (SC), Brazil.

Received from the Centro Hospitalar Unimed de Joinville - Joinville (SC), Brazil and the Hospital Municipal São José - Joinville (SC), Brazil. Financial conflict of interest: The authors state they had no financial support for this project. Dr. Koenig and Dr. Westphal are employed by Centro Hospitalar Unimed. Submitted on June 22, 2010 Accepted on September 20, 2010

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