Direct Medical Costs of Tetanus, Dengue, and Sepsis Patients in an Intensive Care Unit in Vietnam

Abstract

BackgroundCritically ill patients often require complex clinical care by highly trained staff within a specialized intensive care unit (ICU) with advanced equipment. There are currently limited data on the costs of critical care in low-and middle-income countries (LMICs). This study aims to investigate the direct-medical costs of key infectious disease (tetanus, sepsis, and dengue) patients admitted to ICU in a hospital in Ho Chi Minh City (HCMC), Vietnam, and explores how the costs and cost drivers can vary between the different diseases.MethodsWe calculated the direct medical costs for patients requiring critical care for tetanus, dengue and sepsis. Costing data (stratified into different cost categories) were extracted from the bills of patients hospitalized to the adult ICU with a dengue, sepsis and tetanus diagnosis that were enrolled in three studies conducted at the Hospital for Tropical Diseases in HCMC from January 2017 to December 2019. The costs were considered from the health sector perspective. The total sample size in this study was 342 patients.ResultsICU care was associated with significant direct medical costs. For patients that did not require mechanical ventilation, the median total ICU cost per patient varied between US$64.40 and US$675 for the different diseases. The costs were higher for patients that required mechanical ventilation, with the median total ICU cost per patient for the different diseases varying between US$2,590 and US$4,250. The main cost drivers varied according to disease and associated severity.ConclusionThis study demonstrates the notable cost of ICU care in Vietnam and in similar LMIC settings. Future studies are needed to further evaluate the costs and economic burden incurred by ICU patients. The data also highlight the importance of evaluating novel critical care interventions that could reduce the costs of ICU care.

Improving Classification of Tetanus Severity for Patients in Low-Middle Income Countries Wearing ECG Sensors by Using a CNN-Transformer Network

“…If patients do not require mechanical ventilation, the median total ICU cost per patient varied between US$64. 40 and US$675 for the different diseases [9]. If patients required mechanical ventilation, the costs were higher, and the median total ICU cost per patient for the different diseases varied between US$2, 590 and US$4, 250 [9].…”

“…In most low-resource settings this means admission to high-dependency or intensive care units (ICUs) as these are the only places with sufficient staff and equipment to do this. This large burden of additional cases results in suboptimal use of already scare resources and likely worsens outcomes for those who do require ICU level care [9] [10] [11]. Additionally in countries like Vietnam where many patients pay for care outof-pocket, the extra costs of ICU care, compared to normal ward care, are significant.…”

“…Additionally in countries like Vietnam where many patients pay for care outof-pocket, the extra costs of ICU care, compared to normal ward care, are significant. There are the information about direct medical costs of tetanus, dengue, and sepsis patients in an ICU in Vietnam from previous research [9] [10] [11]. If patients do not require mechanical ventilation, the median total ICU cost per patient varied between US$64.…”

“…40 and US$675 for the different diseases [9]. If patients required mechanical ventilation, the costs were higher, and the median total ICU cost per patient for the different diseases varied between US$2, 590 and US$4, 250 [9]. The main cost drivers varied depending on disease and its related severity [9].…”

2D-WinSpatt-Net: A Dual Spatial Self-Attention Vision Transformer Boosts Classification of Tetanus Severity for Patients Wearing ECG Sensors in Low- and Middle-Income Countries

“…In most limited-resource settings, close monitoring and timely emergency treatment are frequently only available in high-dependency wards or ICUs, as these facilities possess the necessary staff and equipment to provide such services. This large burden of additional cases results in suboptimal use of already limited resources and potentially leads to poorer outcomes for individuals in need of intensive care [ 7 , 9 , 10 ]. Furthermore, numerous patients in LMIC (e.g., Vietnam) bear the out-of-pocket medical expenses, and the additional costs associated with ICU care are considerably higher in comparison to standard ward care.…”