Frontiers in Public Health (Jun 2022)

Direct Medical Costs of Tetanus, Dengue, and Sepsis Patients in an Intensive Care Unit in Vietnam

  • Trinh Manh Hung,
  • Nguyen Van Hao,
  • Nguyen Van Hao,
  • Lam Minh Yen,
  • Angela McBride,
  • Angela McBride,
  • Vu Quoc Dat,
  • H. Rogier van Doorn,
  • H. Rogier van Doorn,
  • Huynh Thi Loan,
  • Nguyen Thanh Phong,
  • Martin J. Llewelyn,
  • Behzad Nadjm,
  • Sophie Yacoub,
  • Sophie Yacoub,
  • C. Louise Thwaites,
  • C. Louise Thwaites,
  • Sayem Ahmed,
  • Sayem Ahmed,
  • Nguyen Van Vinh Chau,
  • Hugo C. Turner,
  • The Vietnam ICU Translational Applications Laboratory (VITAL) Investigators,
  • Dang Phuong Thao,
  • Dang Trung Kien,
  • Doan Bui Xuan Thy,
  • Dong Huu Khanh Trinh,
  • Du Hong Duc,
  • Ronald Geskus,
  • Ho Bich Hai,
  • Ho Quang Chanh,
  • Ho Van Hien,
  • Huynh Trung Trieu,
  • Evelyne Kestelyn,
  • Le Dinh Van Khoa,
  • Le Thanh Phuong,
  • Luu Hoai Bao Tran,
  • Luu Phuoc An,
  • Angela Mcbride,
  • Nguyen Lam Vuong,
  • Nguyen Quang Huy,
  • Nguyen Than Ha Quyen,
  • Nguyen Thanh Ngoc,
  • Nguyen Thi Giang,
  • Nguyen Thi Le Thanh,
  • Nguyen Thi Phuong Dung,
  • Nguyen Thi Phuong Thao,
  • Ninh Thi Thanh Van,
  • Phan Nguyen Quoc Khanh,
  • Phung Khanh Lam,
  • Phung Tran Huy Nhat,
  • Guy Thwaites,
  • Tran Minh Duc,
  • Jennifer Ilo Van Nuil,
  • Vu Ngo Thanh Huyen,
  • Cao Thi Tam,
  • Duong Bich Thuy,
  • Ha Thi Hai Duong,
  • Ho Dang Trung Nghia,
  • Le Buu Chau,
  • Le Mau Toan,
  • Le Ngoc Minh Thu,
  • Le Thi Mai Thao,
  • Luong Thi Hue Tai,
  • Nguyen Hoan Phu,
  • Nguyen Quoc Viet,
  • Nguyen Thanh Nguyen,
  • Nguyen Thi Kim Anh,
  • Nguyen Van Thanh Duoc,
  • Pham Kieu Nguyet Oanh,
  • Phan Thi Hong Van,
  • Phan Tu Qui,
  • Phan Vinh Tho,
  • Truong Thi Phuong Thao,
  • Natasha Ali,
  • David Clifton,
  • Mike English,
  • Shadi Ghiasi,
  • Heloise Greeff,
  • Jannis Hagenah,
  • Ping Lu,
  • Jacob McKnight,
  • Chris Paton,
  • Pantelis Georgiou,
  • Bernard Hernandez Perez,
  • Kerri Hill-Cawthorne,
  • Alison Holmes,
  • Stefan Karolcik,
  • Damien Ming,
  • Nicolas Moser,
  • Liane Canas,
  • Alberto Gomez,
  • Hamideh Kerdegari,
  • Marc Modat,
  • Reza Razavi,
  • Linda Denehy,
  • Luigi Pisani,
  • Marcus Schultz

DOI
https://doi.org/10.3389/fpubh.2022.893200
Journal volume & issue
Vol. 10

Abstract

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BackgroundCritically 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.MethodsWe 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.ResultsICU 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.ConclusionThis 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.

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