The impact of bundle care on medical expenses reduction in critically-ill patients with blood stream infection

Abstract

Background:Previous research showed that blood stream infection(BSI) in ICU significantly increased hospital stays and higher medical expenses in the critically ill patients. However, there were few studies analyzed the impacts upon medical expenses after the implementation of bundle care for BSI in different severities of critically ill patients.

OBJECTIVES:To address the impact upon medical expenses in different groups of critically-ill patients with BSI before and after the implementation of bundle care.

METHODS:The database included patients' demographics, classification of diseases, national health insurance payment profile were collected from 2010/1/1 to 2013/12/31. Four groups are categorized based on APACHE II score respectively: APACHE II<15 (Group 1), APACHE 15-25 (Group 2), 26-35 (Group 3), and APACHE> 36 (Group 4). We conducted two-sample t-test to compare patients' medical expenses before (2010-2011) and after (2012-2013) implementation of bundle care.

RESULTS:We have collected 102 patients with BSI in the medical ICU between 1/1/2010 and 12/31/2013.Their mean age is 66.59±14.47 years old. 75 patients (74%) are male, 27 patients (26%) are female. We found significantly lower average medical expenses in group 3 (NT$ 666,865±337,003 vs.462338±290254, p-value=0.039) and total patients (534,236±318,251 vs.449,862±252,769, p-value=0.04)after bundle care implementation .

CONCLUSIONS: The results showed that after introducing bundle care in the medical ICU, more severe critically-ill patients with BSI have significant reduction in average medical expenses during hospitalization.