ABSTRACT
BACKGROUND: Carbapenem resistant-non lactose fermenter (CR-NLF) and Carbapenem resistant-Enterobacteriaceae (CR-E) bacterial infections are likely to be a global threat to people's health. However, studies on the economic impacts according to the hospital setting are very scarce. The study aimed to explore the impact of CR-NLF (Acinetobacter baumannii = CRAB) & Pseudomonas aeruginosa = CRPA) and CR-E (Escherichia coli = CREC) & Klebsiella pneumoniae = CRKP) infections on hospital costs from a payer perspective among patients admitted to Dr.Soetomo Hospital, Surabaya, Indonesia. METHODS: In the retrospective case-control study, medical records of all included patients hospitalized during 2018-2021 were reviewed for CRAB, CRPA, CREC, CRKP, and carbapenem sensitive (CSAB, CSPA, CSEC, CSKP) were collected. We retrieved the data of age, gender, clinical specimen, dates of admission, and discharge status. The outcomes of interest were hospital length of stay and hospitalization cost. RESULTS: The cost for CR-NLFs infections was higher than carbapenem sensitive, $3026.24 versus $1299.28 (p < 0.05). There was no significant difference between CR-E against carbapenem sensitive. It showed that the highest impact of the cost was CRAB, followed by CRPA, CRKP, and CREC. The bed, antibiotics, pharmacy, and diagnostic costs of CR-NLFIs were significantly higher than CR-E. CONCLUSION: This study showed that the hospital cost and expenditure of CR-NLFs per patient were higher than CS. The hospital cost per patient for CR-NLF was higher than CR-E.
ABSTRACT
The first case of Coronavirus disease 2019 (COVID-19) in Indonesia was announced in March 2020. Since then, the number of COVID-19 cases has continued to rise. This prompted the government to adopt Pembatasan Sosial Berskala Besar (PSBB) or large-scale social restrictions (LSSR). Certain areas within dengue fever endemic regions face two challenges: Simultaneously tackling COVID-19 and dengue hemorrhagic fever (DHF). Five economic growth centers (a city and four districts) in East Java Province (Gresik, Bangkalan, Surabaya, Sidoarjo, and Lamongan) were affected by the COVID-19 pandemic and a dengue fever outbreak. This is a quantitative research with a comparative study design that used the Wilcoxon test to compare cases of DHF pre-COVID-19 versus during the COVID-19 pandemic. The Wilcoxon test result showed no significant difference at a p-value of 0.319 (p-value > 0.05). It can be concluded that DHF still became a challenge in five regions in East Java Province, even though LSSR were implemented. Additional effort is required to tackle DHF. A method of preventing and controlling DHF during the COVID-19 pandemic is to build community independence through the "one house, one health cadre movement." Keywords: COVID-19, dengue hemorrhagic fever, large-scale social restrictions