Incremental cost of treating antimicrobial-resistant infections among hospitalised patients in India: a cohort study
Background Accurate estimates of incremental cost (IC) attributable to antimicrobial resistance (AMR) provide information of immense public health importance to the policy makers. Here, we present the IC from patient perspective for treating antimicrobial-resistant pathogens in India.Methods This co...
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BMJ Publishing Group
2024-12-01
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| author | Sanjay M Mehendale Kamini Walia Pallab Ray Nusrat Shafiq Shankar Prinja Sagar Khadanga Susmita Chatterjee Raman Gangakhedkar Samiran Panda Sanjay Bhattacharya Megha Mamulwar Abhijit Kadam Gayatri Bhambure Shilpa Bembalkar Shraddha Bapat Arati Mane Shobha Rajure Jayanthi Mathaiyan Yamunadevi Ramanathan Vijayshri Suresh Deotale Gourangie Gogoi Ruchita Attal Jharna Mandal Venkateswaran Ramanathan |
| author_facet | Sanjay M Mehendale Kamini Walia Pallab Ray Nusrat Shafiq Shankar Prinja Sagar Khadanga Susmita Chatterjee Raman Gangakhedkar Samiran Panda Sanjay Bhattacharya Megha Mamulwar Abhijit Kadam Gayatri Bhambure Shilpa Bembalkar Shraddha Bapat Arati Mane Shobha Rajure Jayanthi Mathaiyan Yamunadevi Ramanathan Vijayshri Suresh Deotale Gourangie Gogoi Ruchita Attal Jharna Mandal Venkateswaran Ramanathan |
| author_sort | Sanjay M Mehendale |
| collection | DOAJ |
| description | Background Accurate estimates of incremental cost (IC) attributable to antimicrobial resistance (AMR) provide information of immense public health importance to the policy makers. Here, we present the IC from patient perspective for treating antimicrobial-resistant pathogens in India.Methods This cohort study was conducted in eight hospitals including government (GH), private (PH) and trust hospitals (TH), considering their ownership, geographical location and categories of cities. This study had a retrospective component, which calculated the direct cost of treating resistant and susceptible blood stream infections caused by selected WHO priority pathogens. The prospective component estimated indirect cost and financial coping strategies for the treatment of AMR. In the retrospective component, 1723 records were included and 170 patients were recruited in the prospective component.Results The median total cost for management of antimicrobial-resistant infections was US$199 (IQR 89, 377) as opposed to US$109 (IQR 55, 229) for susceptible infection in GH. Our study has revealed that the ICs for Enterobacteriaceae (53.9%), Acinetobacter (43.8%) and Staphylococcus (49.7%) at GHs were higher for resistant pathogens. Pharmaceutical cost was the major contributor to IC at GHs (61.5%) and PHs (27.1%). In the prospective component, 46.5% of patients resorted to borrowing money for hospitalisation expenses and the per day median total cost for resistant and sensitive infection was estimated to be US$65 and US$35, respectively.Conclusions The current study concluded that the presence of any critical or high priority pathogens led to an increase in the direct and indirect medical costs. The IC varied with hospital type, length of stay, pathogen, comorbidities and diagnosis. Prospective studies are needed for precise understanding of variations in the costs of treating AMR infections. |
| format | Article |
| id | doaj-art-c7b908e8428841bc84c8a06bc6d336e1 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-12-01 |
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| spelling | doaj-art-c7b908e8428841bc84c8a06bc6d336e12025-01-14T15:50:15ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-086505Incremental cost of treating antimicrobial-resistant infections among hospitalised patients in India: a cohort studySanjay M Mehendale0Kamini Walia1Pallab Ray2Nusrat Shafiq3Shankar Prinja4Sagar Khadanga5Susmita Chatterjee6Raman Gangakhedkar7Samiran Panda8Sanjay Bhattacharya9Megha Mamulwar10Abhijit Kadam11Gayatri Bhambure12Shilpa Bembalkar13Shraddha Bapat14Arati Mane15Shobha Rajure16Jayanthi Mathaiyan17Yamunadevi Ramanathan18Vijayshri Suresh Deotale19Gourangie Gogoi20Ruchita Attal21Jharna Mandal22Venkateswaran Ramanathan236 PD Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra, India11 Indian Council of Medical Research, New Delhi, Delhi, India4 Post Graduate Institute of Medical Education and Research, Chandigarh, IndiaPharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, IndiaDepartment of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India8 All India Institute of Medical Science, Bhopal, Madhya Pradesh, India13 The George Institute for Global Health India, New Delhi, Delhi, India12 Faculty of Medical and Health Sciences, Symbiosis International (Deemed University), Pune, Manaharashtra, India11 Indian Council of Medical Research, New Delhi, Delhi, India9 Tata Medical Center, Kolkata, West Bengal, India1 National AIDS Research Institute, Pune, Maharashtra, India1 National AIDS Research Institute, Pune, Maharashtra, India1 National AIDS Research Institute, Pune, Maharashtra, India1 National AIDS Research Institute, Pune, Maharashtra, India2 Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India1 National AIDS Research Institute, Pune, Maharashtra, India1 National AIDS Research Institute, Pune, Maharashtra, India3 Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India5 Apollo Hospital, Chennai, India7 Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra, India10 Assam Medical College and Hospital, Dibrugarh, Assam, India7 Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra, India3 Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India3 Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, IndiaBackground Accurate estimates of incremental cost (IC) attributable to antimicrobial resistance (AMR) provide information of immense public health importance to the policy makers. Here, we present the IC from patient perspective for treating antimicrobial-resistant pathogens in India.Methods This cohort study was conducted in eight hospitals including government (GH), private (PH) and trust hospitals (TH), considering their ownership, geographical location and categories of cities. This study had a retrospective component, which calculated the direct cost of treating resistant and susceptible blood stream infections caused by selected WHO priority pathogens. The prospective component estimated indirect cost and financial coping strategies for the treatment of AMR. In the retrospective component, 1723 records were included and 170 patients were recruited in the prospective component.Results The median total cost for management of antimicrobial-resistant infections was US$199 (IQR 89, 377) as opposed to US$109 (IQR 55, 229) for susceptible infection in GH. Our study has revealed that the ICs for Enterobacteriaceae (53.9%), Acinetobacter (43.8%) and Staphylococcus (49.7%) at GHs were higher for resistant pathogens. Pharmaceutical cost was the major contributor to IC at GHs (61.5%) and PHs (27.1%). In the prospective component, 46.5% of patients resorted to borrowing money for hospitalisation expenses and the per day median total cost for resistant and sensitive infection was estimated to be US$65 and US$35, respectively.Conclusions The current study concluded that the presence of any critical or high priority pathogens led to an increase in the direct and indirect medical costs. The IC varied with hospital type, length of stay, pathogen, comorbidities and diagnosis. Prospective studies are needed for precise understanding of variations in the costs of treating AMR infections.https://bmjopen.bmj.com/content/14/12/e086505.full |
| spellingShingle | Sanjay M Mehendale Kamini Walia Pallab Ray Nusrat Shafiq Shankar Prinja Sagar Khadanga Susmita Chatterjee Raman Gangakhedkar Samiran Panda Sanjay Bhattacharya Megha Mamulwar Abhijit Kadam Gayatri Bhambure Shilpa Bembalkar Shraddha Bapat Arati Mane Shobha Rajure Jayanthi Mathaiyan Yamunadevi Ramanathan Vijayshri Suresh Deotale Gourangie Gogoi Ruchita Attal Jharna Mandal Venkateswaran Ramanathan Incremental cost of treating antimicrobial-resistant infections among hospitalised patients in India: a cohort study BMJ Open |
| title | Incremental cost of treating antimicrobial-resistant infections among hospitalised patients in India: a cohort study |
| title_full | Incremental cost of treating antimicrobial-resistant infections among hospitalised patients in India: a cohort study |
| title_fullStr | Incremental cost of treating antimicrobial-resistant infections among hospitalised patients in India: a cohort study |
| title_full_unstemmed | Incremental cost of treating antimicrobial-resistant infections among hospitalised patients in India: a cohort study |
| title_short | Incremental cost of treating antimicrobial-resistant infections among hospitalised patients in India: a cohort study |
| title_sort | incremental cost of treating antimicrobial resistant infections among hospitalised patients in india a cohort study |
| url | https://bmjopen.bmj.com/content/14/12/e086505.full |
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