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The difference in medical costs between carbapenem-resistant Acinetobacter baumannii and non-resistant groups: a case study from a hospital in Zhejiang province, China

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Abstract

This retrospective study aims to compare differences in the medical costs between inpatients infected/colonised with carbapenem-resistant (CRAB) and carbapenem-susceptible (CSAB) Acinetobacter baumannii in a hospital in Zhejiang province, China. Because the patient population was large, we randomly selected 60% of all inpatients with clinical specimens between 2013 and 2015. We classified the A. baumannii cases as CRAB or CSAB based on antibiotic susceptibility testing. Univariate and multivariate analyses were used to identify factors associated with the total medical cost (TMC). Those included in the study totalled 2980 inpatients, 71.3% of whom had CRAB infection/colonisation. Differences in the TMC between the CRAB and CSAB groups were lower by multivariate analyses than the differences obtained by univariate analyses. Carbapenem resistance was significantly associated with an approximately 1.5-fold increase in the TMC after accounting for confounding factors. Our study highlights the heavy financial burden imposed by A. baumannii and carbapenem resistance on the Chinese healthcare system.

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Acknowledgements

It is acknowledged that, in the data collection, we obtained valuable help from the Center for Health Policy Studies, School of Medicine, Zhejiang University. We also appreciate the help of Prof. Yi Shen (School of Medicine, Zhejiang University) for the methodological support. The study was supported by Pfizer Investment Co. Ltd.

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Authors and Affiliations

  1. Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China

    X. Zhen, X. Hu, S. Gu & H. Dong

  2. Pfizer Investment Co. Ltd., Beijing, China

    Y. Chen & P. Dong

  3. Princeton University, Princeton, NJ, USA

    Y. Y. Sheng

  4. China Hospital Development Institute, Shanghai Jiaotong University, Shanghai, China

    H. Dong

Authors
  1. X. Zhen
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  2. Y. Chen
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  3. X. Hu
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  4. P. Dong
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  5. S. Gu
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  6. Y. Y. Sheng
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  7. H. Dong
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Contributions

XZ participated in the conception and design of the study, in the collection of data, performed the analysis and interpretation of data, drafted and revised the manuscript. YC and PD helped in the manuscript drafting and revising. XH and SG participated in the analysis of data and helped in the drafting and revising of the manuscript. YYS helped in the manuscript revising. HD participated in the conception and design of the study, data collection and helped in the drafting and revising of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to H. Dong.

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Conflict of interest

The views expressed in this paper are those of the authors and not the Pfizer Investment Co. Ltd. All authors declare that they have no conflict of interest.

Ethical approval and informed consent

The study was approved by the institutional review board of Zhejiang University School of Public Health, who waived the need for informed consent. All patient data were anonymised prior to analysis.

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Cite this article

Zhen, X., Chen, Y., Hu, X. et al. The difference in medical costs between carbapenem-resistant Acinetobacter baumannii and non-resistant groups: a case study from a hospital in Zhejiang province, China. Eur J Clin Microbiol Infect Dis 36, 1989–1994 (2017). https://doi.org/10.1007/s10096-017-3088-3

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  • DOI: https://doi.org/10.1007/s10096-017-3088-3

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