Estimating the savings of a national project to prevent healthcare-associated infections in intensive care units.

BACKGROUND: Healthcare-associated infections (HAIs) have a significant impact on patients' morbidity and mortality, and have a detrimental financial impact on the healthcare system. Various strategies exist to prevent HAIs, but economic evaluations are needed to determine which are most appropriate. AIM: To present the financial impact of a nationwide project on HAI prevention in intensive care units (ICUs) using a quality improvement (QI) approach. METHODS: A health economic evaluation assessed the financial results of the QI initiative 'Saúde em Nossas Mãos' (SNM), implemented in Brazil between January 2018 and December 2020. Among 116 participating institutions, 13 (11.2%) fully reported the aggregate cost and stratified patients (with vs without HAIs) in the pre-intervention and post-intervention periods. Average cost (AC) was calculated for each analysed HAI: central-line-associated bloodstream infections (CLABSIs), ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infections (CAUTIs). The absorption model and time-driven activity-based costing were used for cost estimations. The numbers of infections that the project could have prevented during its implementation were estimated to demonstrate the financial impact of the SNM initiative. RESULTS: The aggregated ACs calculated for each HAI from these 13 ICUs - US$8480 for CLABSIs, US$10,039 for VAP, and US$7464 for CAUTIs - were extrapolated to the total number of HAIs prevented by the project (1727 CLABSIs, 3797 VAP and 2150 CAUTIs). The overall savings of the SNM as of December 2020 were estimated at US$68.8 million, with an estimated return on investment (ROI) of 765%. CONCLUSION: Reporting accurate financial data on HAI prevention strategies is still challenging in Brazil. These results suggest that a national QI initiative to prevent HAIs in critical care settings is a feasible and value-based approach, reducing financial waste and yielding a significant ROI for the healthcare system.

Oxidative stability of yogurt with added lutein dye.

This study evaluated the effect of adding lutein dye on the oxidative stability of yogurt during 35 d of refrigerated storage, in the presence and absence of light. Yogurts manufactured without and with the equivalent of 1.5mg of lutein in 120 g of the final product were characterized for their total carotenoid and riboflavin contents, and the behaviors of both riboflavin and lutein were monitored during storage. A decrease in riboflavin content occurred, with concurrent appearance of its derived-oxidation products in the yogurts without added lutein and exposed to light during storage. The yogurts with added lutein dye showed constant lutein and riboflavin contents throughout storage both for the samples stored under light and for those stored in the dark. Yogurts (120 g) with the addition of 0.5, 1.5, and 2.5mg of lutein dye were evaluated for their sensory acceptance, and the statistical analysis showed no differences between the samples for the attributes of aroma and flavor. These results indicate that the added lutein remained stable throughout the storage period and conferred protection for the riboflavin against photooxidation, preserving the quality of the yogurts.