Biomedical subjects

Akos Csomós

Publications and source records attributed to Akos Csomós.

3 recordsLinked to original sources

PubMed2005

[The incidence and cost of severe sepsis in intensive care units].

OBJECTIVES: The aim of the study was to determine the incidence and mortality of sepsis and to analyse the direct costs of severe sepsis treated in intensive care unit in Hungary. METHOD: National data on sepsis demography, incidence and mortality were collected using the database of Hungarian Health Fund, Year 2001. The cost of treating severe sepsis was calculated by retrospective data collection of resource use in 6 ICUs. Personnel costs were calculated from annual salary report and the indirect costs were estimated by the financial director of each participating hospital. To validate retrospective data, the ICUs organised a prospective cost-analysis during one month period. RESULTS: There were 2659 patients reported with septic DRG code in Hungary. The mortality of sepsis is 42.7%, the average length of stay is 14.5 days (SD-17.4). Patients discharged from ICU after sepsis remained in hospital for further 18.1 days (SD-18). The mortality of severe sepsis in the pilot sample (n = 70) was found to be 64.2%, with average length of stay 15.5 (SD-10.2). The average daily ICU cost of severe sepsis is HUF 107 200 (429 Euro). Consumables account for 68% of total cost, the personnel 26.3% and clinical support 5.7%. CONCLUSION: The mortality of severe sepsis is high and the cost of treating severe sepsis is four times more then the average ICU daily cost. To take into account the much longer length of stay (15.5 vs. 5 day), annual cost of septic patients is HUF 4.4 billions (1 140000 Euro) in Hungary.

Costs and Cost Analysis↗

PubMed2005

Comparative costing analysis of intensive care services between Hungary and United Kingdom.

OBJECTIVE: The study presents the findings of the first National Intensive Care Cost Block Analysis in Hungary. METHODS: There were 13 Intensive Care Units (ICUs) involved in this study: 5 University Hospitals, 6 District County Hospitals and 2 City Hospitals. The annual costs of ICUs were measured by "top-down" approach based on Cost Block Method. Annual expenditure of 3 cost blocks was collected for year 2000: clinical support, consumables and staff costs. On top of the annual costs, we collected general ICU data and Top 10 drugs of each unit. Our data was compared to National Cost Block data of United Kingdom. RESULTS: There were 9313 patients involved in the study. The median (IQR) ICU occupancy rate was 67% (62-79), mortality was 21% (11-26). The mean cost per bed was 30,990 Euro (SD 12,573) and 144 Euro (SD 63,1) per patient day. Clinical support services were accounted for 9.6% of resources, consumables for 60.6% and staff costs for 29.8%. CONCLUSIONS: Intensive care costs are very low in Hungary compared to other European countries. The difference is explained by the cheaper staff cost, but the lower number of nurses per ICU bed contributes as well.

Costs and Cost Analysis↗

PubMed2003

[Comparative analysis in artificial nutrition].

INTRODUCTION: It is well known to Hungarian experts in the field of nutrition that hospital inpatients in this country do not have the required nutrition. AIM: To compare data of intensive care national costing analysis from England and intensive care unit in County Hospital, Eger, Hungary in order to advise a cost effective nutrition protocol. METHOD: English data were extracted from the report of Intensive Care National Cost Block Programme, year 1999. The Hungarian data were obtained by top down method from annual costing report of the same year. The authors used Purchasing Power Parity to make international cost comparison between these countries. RESULTS: In proportion to Purchasing Power Parity, the hospital budget per patient for nutrition is more than double in England than in the studied intensive care unit in Hungary. Intensive care units in England spend 1% on nutrition, 13% on drugs and 10% on disposables. There is only 0.2% spent on nutrition, 29.8% on drugs and 8% on disposables in the studied intensive care unit in Hungary. Cost of nutrition per patient day is HUF 117 in Hungary, which is even lower than the hospital budget per patient day for nutrition. CONCLUSION: On the basis of the above findings and literature review as well, the authors set up a cost effective nutrition guideline: 1. Identify malnourished patient. 2. Nutrition can be delayed for 4-5 days in not malnourished patient. 3. Enteral nutrition should always be the first choice. 4. Total parenteral nutrition is beneficial only if given over at least 7 days. 5) It is cost effective to prevent nosocomial infections even at higher cost.

Cost-Benefit Analysis↗