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1.
Braz J Infect Dis ; 25(4): 101609, 2021.
Article in English | MEDLINE | ID: covidwho-1363890

ABSTRACT

INTRODUCTION: Although patients' clinical conditions have been shown to be associated with coronavirus disease (COVID-19) severity and outcome, their impact on hospital costs are not known. This economic evaluation of COVID-19 admissions aimed to assess direct and fixed hospital costs and describe their particularities in different clinical and demographic conditions and outcomes in the largest public hospital in Latin America, located in São Paulo, Brazil, where a whole institute was exclusively dedicated to COVID-19 patients in response to the pandemic. METHODS: This is a partial economic evaluation performed from the hospital´s perspective and is a prospective, observational cohort study to assess hospitalization costs of suspected and confirmed COVID-19 patients admitted between March 30 and June 30, 2020, to Hospital das Clínicas of the University of São Paulo Medical School (HCFMUSP) and followed until discharge, death, or external transfer. Micro- and macro-costing methodologies were used to describe and analyze the total cost associated with each patient's underlying medical conditions, itinerary and outcomes as well as the cost components of different hospital sectors. RESULTS: The average cost of the 3254 admissions (51.7% of which involved intensive care unit stays) was US$12,637.42. The overhead cost was its main component. Sex, age and underlying hypertension (US$14,746.77), diabetes (US$15,002.12), obesity (US$18,941.55), chronic renal failure (US$15,377.84), and rheumatic (US$17,764.61), hematologic (US$15,908.25) and neurologic (US$15,257.95) diseases were associated with higher costs. Age strata >69 years, reverse transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19, comorbidities, use of mechanical ventilation or dialysis, surgery and outcomes remained associated with higher costs. CONCLUSION: Knowledge of COVID-19 hospital costs can aid in the development of a comprehensive approach for decision-making and planning for future risk management.


Subject(s)
COVID-19 , Hospital Costs , Aged , Brazil/epidemiology , Demography , Hospitalization , Humans , Prospective Studies , SARS-CoV-2
4.
J. bras. pneumol ; 46(3):e20200216-e20200216, 2020.
Article in English | LILACS (Americas), Grey literature | ID: grc-742417
5.
Ferreira, Juliana C.; Ho, Yeh-Li, Besen, Bruno A. M. P.; Malbuisson, Luiz M. S.; Taniguchi, Leandro U.; Mendes, Pedro V.; Costa, Eduardo L. V.; Park, Marcelo, Daltro-Oliveira, Renato, Roepke, Roberta M. L.; Silva Jr, João M.; Carmona, Maria José C.; Carvalho, Carlos Roberto Ribeiro, Hirota, Adriana, Kanasiro, Alberto Kendy, Crescenzi, Alessandra, Fernandes, Amanda Coelho, Miethke-Morais, Anna, Bellintani, Arthur Petrillo, Canasiro, Artur Ribeiro, Carneiro, Bárbara Vieira, Zanbon, Beatriz Keiko, Batista, Bernardo Pinheiro De Senna Nogueira, Nicolao, Bianca Ruiz, Besen, Bruno Adler Maccagnan Pinheiro, Biselli, Bruno, Macedo, Bruno Rocha De, Toledo, Caio Machado Gomes De, Pompilio, Carlos Eduardo, Carvalho, Carlos Roberto Ribeiro De, Mol, Caroline Gomes, Stipanich, Cassio, Bueno, Caue Gasparotto, Garzillo, Cibele, Tanaka, Clarice, Forte, Daniel Neves, Joelsons, Daniel, Robira, Daniele, Costa, Eduardo Leite Vieira, Silva Júnior, Elson Mendes Da, Regalio, Fabiane Aliotti, Segura, Gabriela Cardoso, Marcelino, Gustavo Brasil, Louro, Giulia Sefrin, Ho, Yeh-Li, Ferreira, Isabela Argollo, Gois, Jeison de Oliveira, Silva Junior, Joao Manoel Da, Reusing Junior, Jose Otto, Ribeiro, Julia Fray, Ferreira, Juliana Carvalho, Galleti, Karine Vusberg, Silva, Katia Regina, Isensee, Larissa Padrao, Oliveira, Larissa dos Santos, Taniguchi, Leandro Utino, Letaif, Leila Suemi, Lima, Lígia Trombetta, Park, Lucas Yongsoo, Chaves Netto, Lucas, Nobrega, Luciana Cassimiro, Haddad, Luciana, Hajjar, Ludhmila, Malbouisson, Luiz Marcelo, Pandolfi, Manuela Cristina Adsuara, Park, Marcelo, Carmona, Maria José Carvalho, Andrade, Maria Castilho Prandini H. De, Santos, Mariana Moreira, Bateloche, Matheus Pereira, Suiama, Mayra Akimi, Oliveira, Mayron Faria de, Sousa, Mayson Laercio, Louvaes, Michelle, Huemer, Natassja, Mendes, Pedro, Lins, Paulo Ricardo Gessolo, Santos, Pedro Gaspar Dos, Moreira, Pedro Ferreira Paiva, Guazzelli, Renata Mello, Reis, Renato Batista Dos, Oliveira, Renato Daltro De, Roepke, Roberta Muriel Longo, Pedro, Rodolpho Augusto De Moura, Kondo, Rodrigo, Rached, Samia Zahi, Fonseca, Sergio Roberto Silveira Da, Borges, Thais Sousa, Ferreira, Thalissa, Cobello Junior, Vilson, Sales, Vivian Vieira Tenório, Ferreira, Willaby Serafim Cassa, Group, E. PICCoV Study.
Clinics ; 75:e2294-e2294, 2020.
Article in English | LILACS (Americas), Grey literature | ID: grc-742344

ABSTRACT

OBJECTIVES: We designed a cohort study to describe characteristics and outcomes of patients with coronavirus disease (COVID-19) admitted to the intensive care unit (ICU) in the largest public hospital in Sao Paulo, Brazil, as Latin America becomes the epicenter of the pandemic. METHODS: This is the protocol for a study being conducted at an academic hospital in Brazil with 300 adult ICU beds dedicated to COVID-19 patients. We will include adult patients admitted to the ICU with suspected or confirmed COVID-19 during the study period. The main outcome is ICU survival at 28 days. Data will be collected prospectively and retrospectively by trained investigators from the hospital's electronic medical records, using an electronic data capture tool. We will collect data on demographics, comorbidities, severity of disease, and laboratorial test results at admission. Information on the need for advanced life support and ventilator parameters will be collected during ICU stay. Patients will be followed up for 28 days in the ICU and 60 days in the hospital. We will plot Kaplan-Meier curves to estimate ICU and hospital survival and perform survival analysis using the Cox proportional hazards model to identify the main risk factors for mortality. ClinicalTrials.gov: NCT04378582. RESULTS: We expect to include a large sample of patients with COVID-19 admitted to the ICU and to be able to provide data on admission characteristics, use of advanced life support, ICU survival at 28 days, and hospital survival at 60 days. CONCLUSIONS: This study will provide epidemiological data about critically ill patients with COVID-19 in Brazil, which could inform health policy and resource allocation in low- and middle-income countries.

7.
Braz J Infect Dis ; 24(6): 570-574, 2020.
Article in English | MEDLINE | ID: covidwho-893643

ABSTRACT

As of August 30, 2020, Brazil ranked second among countries with the highest number of COVID-19 cases, with the city of São Paulo as the national epidemic epicenter. Local public healthcare institutions were challenged to respond to a fast-growing hospital demand, reengineering care provision to optimize clinical outcomes and minimize intra-hospital coronavirus infection. In this paper we describe how the largest public hospital complex in Latin America faced this unprecedented burden, managing severe COVID-19 cases while sustaining specialized care to patients with other conditions. In our strategic plan a 900-bed hospital was exclusively designated for COVID-19 care and continuity of care to those not infected with coronavirus ensured in other inpatient facilities. After 152 days, 4241 patients with severe COVID-19 were hospitalized, 70% of whom have already been discharged, whereas the remaining Institutes of the complex successfully maintained high complexity inpatient and urgent/emergency care to non-COVID-19 patients.


Subject(s)
COVID-19 , Coronavirus Infections , Hospitals, Public , Pneumonia, Viral , Brazil , Cities , Continuity of Patient Care , Coronavirus Infections/epidemiology , Humans , Latin America , Pandemics , Pneumonia, Viral/epidemiology , SARS-CoV-2
9.
Ferreira, Juliana C; Ho, Yeh-Li; Besen, Bruno A M P; Malbuisson, Luiz M S; Taniguchi, Leandro U; Mendes, Pedro V; Costa, Eduardo L V; Park, Marcelo; Daltro-Oliveira, Renato; Roepke, Roberta M L; Silva Jr, João M; Carmona, Maria José C; Carvalho, Carlos Roberto Ribeiro; Hirota, Adriana; Kanasiro, Alberto Kendy; Crescenzi, Alessandra; Fernandes, Amanda Coelho; Miethke-Morais, Anna; Bellintani, Arthur Petrillo; Canasiro, Artur Ribeiro; Carneiro, Bárbara Vieira; Zanbon, Beatriz Keiko; Batista, Bernardo Pinheiro De Senna Nogueira; Nicolao, Bianca Ruiz; Besen, Bruno Adler Maccagnan Pinheiro; Biselli, Bruno; Macedo, Bruno Rocha De; Toledo, Caio Machado Gomes De; Pompilio, Carlos Eduardo; Carvalho, Carlos Roberto Ribeiro De; Mol, Caroline Gomes; Stipanich, Cassio; Bueno, Caue Gasparotto; Garzillo, Cibele; Tanaka, Clarice; Forte, Daniel Neves; Joelsons, Daniel; Robira, Daniele; Costa, Eduardo Leite Vieira; Silva Júnior, Elson Mendes Da; Regalio, Fabiane Aliotti; Segura, Gabriela Cardoso; Marcelino, Gustavo Brasil; Louro, Giulia Sefrin; Ho, Yeh-Li; Ferreira, Isabela Argollo; Gois, Jeison de Oliveira; Silva Junior, Joao Manoel Da; Reusing Junior, Jose Otto; Ribeiro, Julia Fray; Ferreira, Juliana Carvalho; Galleti, Karine Vusberg; Silva, Katia Regina; Isensee, Larissa Padrao; Oliveira, Larissa dos Santos; Taniguchi, Leandro Utino; Letaif, Leila Suemi; Lima, Lígia Trombetta; Park, Lucas Yongsoo; Chaves Netto, Lucas; Nobrega, Luciana Cassimiro; Haddad, Luciana; Hajjar, Ludhmila; Malbouisson, Luiz Marcelo; Pandolfi, Manuela Cristina Adsuara; Park, Marcelo; Carmona, Maria José Carvalho; Andrade, Maria Castilho Prandini H De; Santos, Mariana Moreira; Bateloche, Matheus Pereira; Suiama, Mayra Akimi; Oliveira, Mayron Faria de; Sousa, Mayson Laercio; Louvaes, Michelle; Huemer, Natassja; Mendes, Pedro; Lins, Paulo Ricardo Gessolo; Santos, Pedro Gaspar Dos; Moreira, Pedro Ferreira Paiva; Guazzelli, Renata Mello; Reis, Renato Batista Dos; Oliveira, Renato Daltro De; Roepke, Roberta Muriel Longo; Pedro, Rodolpho Augusto De Moura; Kondo, Rodrigo; Rached, Samia Zahi; Fonseca, Sergio Roberto Silveira Da; Borges, Thais Sousa; Ferreira, Thalissa; Cobello Junior, Vilson; Sales, Vivian Vieira Tenório; Ferreira, Willaby Serafim Cassa.
Clinics ; 75: e2294, 2020. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-769762

ABSTRACT

OBJECTIVES: We designed a cohort study to describe characteristics and outcomes of patients with coronavirus disease (COVID-19) admitted to the intensive care unit (ICU) in the largest public hospital in Sao Paulo, Brazil, as Latin America becomes the epicenter of the pandemic. METHODS: This is the protocol for a study being conducted at an academic hospital in Brazil with 300 adult ICU beds dedicated to COVID-19 patients. We will include adult patients admitted to the ICU with suspected or confirmed COVID-19 during the study period. The main outcome is ICU survival at 28 days. Data will be collected prospectively and retrospectively by trained investigators from the hospital's electronic medical records, using an electronic data capture tool. We will collect data on demographics, comorbidities, severity of disease, and laboratorial test results at admission. Information on the need for advanced life support and ventilator parameters will be collected during ICU stay. Patients will be followed up for 28 days in the ICU and 60 days in the hospital. We will plot Kaplan-Meier curves to estimate ICU and hospital survival and perform survival analysis using the Cox proportional hazards model to identify the main risk factors for mortality. ClinicalTrials.gov: NCT04378582. RESULTS: We expect to include a large sample of patients with COVID-19 admitted to the ICU and to be able to provide data on admission characteristics, use of advanced life support, ICU survival at 28 days, and hospital survival at 60 days. CONCLUSIONS: This study will provide epidemiological data about critically ill patients with COVID-19 in Brazil, which could inform health policy and resource allocation in low- and middle-income countries.


Subject(s)
Humans , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Pneumonia, Viral/therapy , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Coronavirus Infections/therapy , Research Design , Brazil , Cohort Studies , Hospital Mortality , Observational Studies as Topic , Pandemics , Betacoronavirus , SARS-CoV-2 , COVID-19 , Hospitals, University , Intensive Care Units
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