Financial impact of healthcare-associated infections on intensive care units estimated for fifty Brazilian university hospitals affiliated to the unified health system.

BACKGROUND: Studies show that healthcare-associated infections (HAIs) represent a crucial issue in healthcare and can lead to substantial economic impacts in intensive care units (ICUs). AIM: To estimate direct costs associated with the most significant HAIs in 50 teaching hospitals in Brazil, affiliated to the unified health system (Sistema Único de Saúde: SUS). METHODS: A Monte Carlo simulation model was designed to estimate the direct costs of HAIs; first, epidemiologic and economic parameters were established for each HAI based on a cohort of 949 critical patients (800 without HAI and 149 with); second, simulation based on three Brazilian prevalence scenarios of HAIs in ICU patients (29.1%, 51.2%, and 61.6%) was used; and third, the annual direct costs of HAIs in 50 university hospitals were simulated. FINDINGS: Patients with HAIs had 16 additional days in the ICU, along with an extra direct cost of US$13.892, compared to those without HAIs. In one hypothetical scenario without HAI, the direct annual cost of hospital care for 26,649 inpatients in adult ICUs of 50 hospitals was US$112,924,421. There was an increase of approximately US$56 million in a scenario with 29.1%, and an increase of US$147 million in a scenario with 61.6%. The impact on the direct cost became significant starting at a 10% prevalence of HAIs, where US$2,824,817 is added for each 1% increase in prevalence. CONCLUSION: This analysis provides robust and updated estimates showing that HAI places a significant financial burden on the Brazilian healthcare system and contributes to a longer stay for inpatients.

Costs of healthcare-associated infections to the Brazilian public Unified Health System in a tertiary-care teaching hospital: a matched case-control study.

BACKGROUND: Little is known about the economic burden of healthcare-associated infections (HAIs) in Brazil. AIM: To analyse the costs of hospitalization by reimbursement from the Brazilian government, via the Brazilian Unified Health System (SUS) affiliation, and direct costs in the adult Intensive Care Unit (ICU). METHODS: The matched-pairs case-control study (83 patients with HAIs and 83 without HAIs) was performed at a referral tertiary-care teaching hospital in Brazil in January 2018. In order to calculate the HAI costs from the perspective of the payer, the total cost for each hospitalization was obtained through the Hospital's Billing Sector. Direct costs were calculated annually for 949 critical patients during 2018. FINDINGS: The reimbursement cost per hospitalization of patients with HAIs was 75% (US$2721) higher than patients without HAIs (US$1553). When a patient has an HAI, in addition to a longer length of stay (15 days), there was an extra increase (US$996) in the reimbursement cost per hospitalization. An HAI in the ICU was associated with a total direct cost eight times higher compared with patients who did not develop infections in this unit, US$11,776 × US$1329, respectively. The direct cost of hospitalization in the ICU without HAI was 56.5% less than the reimbursement (US$1329 × US$3052, respectively), whereas for the patient with an HAI, the direct cost was 111.5% above the reimbursement (US$11,776 × US$5569, respectively). CONCLUSION: HAIs contribute to a longer stay and an eight-fold increase in direct costs. It is necessary to reinforce programmes that prevent HAIs in Brazilian hospitals.

Efeito do consumo de óleo de linhaça e de vitamina E no desempenho e nas características de carcaças de frangos de corte / Effect of linseed oil and vitamin E consumption on poultry performance and carcass traits

Foi avaliado o efeito da utilização de óleo de linhaça na ração, em substituição ao óleo de soja em diferentes proporções, e de vitamina E, até o nível de 400mg/kg de ração, sobre o desempenho e a composição de carcaça de frangos de corte. O desempenho produtivo foi avaliado com base em pesagens das aves e da ração aos 21 e 49 dias de idade. No 49º dia, as aves foram abatidas, e os rendimentos de carcaça e dos principais cortes comerciais e a porcentagem de vísceras e de gordura abdominal foram avaliados. A composição da fração oleosa da ração, de forma geral, não interferiu nos parâmetros de desempenho avaliados (P>0,05). Os machos consumiram mais ração e ganharam mais peso que as fêmeas (P<0,01). As fêmeas apresentaram, em geral, pior conversão alimentar, associada à maior deposição de gordura abdominal. Os machos apresentaram maior porcentagem de coxa com sobrecoxa em relação ao peso da carcaça eviscerada, e as fêmeas apresentaram maior porcentagem de peito. A porcentagem de asas e vísceras não diferiu entre os sexos.

The effect of the utilization of linseed oil at different concentrations in poultry feed instead of soy oil and the effect of vitamin E administration up to 400mg/kg feed on performance and carcass traits of broilers was investigated. Productive parameters were determined by weighting birds and rations at 21 and 49 days of experiment. Broilers were slaughtered on the 49th day of the experiment for the evaluation of yields of carcass and main cuts, percentages of viscera and abdominal fat. The oil composition of rations did not influence the performance of the broilers (P>0.05). Male broilers had higher feed consumption and weight gain (P<0.05). Female broilers showed worse feed conversion and higher deposition of abdominal fat (P<0.05). Male broilers also had higher percentages of legs and forelegs in relation the weight of the eviscerated carcass while females showed higher breast percentage (P<0.05). Percentages of wings and viscera did not differ between genders (P>0.05).