Costs and Extra Length of Stay because of Neonatal Bloodstream Infection at a Teaching Hospital in Ghana.
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Adis
Abstract
There are no published studies on the costs of hospital-acquired neonatal bloodstream infection (BSI) in Ghana.
Therefore, this study aims to calculate the cost and extra length of stay (LOS) of neonatal BSI. A prospective case–control
study was undertaken at the neonatal intensive care unit (NICU) of Korle Bu Teaching Hospital (KBTH) in Ghana.
Methods The clinical data of 357 neonates were prospectively analysed. Overall, 100 neonates with BSI and 100 control
neonates without BSI were matched by weight, sex and type of delivery. The direct and indirect costs to neonates and their
caregivers was obtained on a daily basis. The cost of drugs was confrmed with the Pharmacy Department at KBTH. A
count data model, specifcally negative binomial regression, was employed to estimate the extra LOS in the NICU due to
neonatal BSI. The study analyzed the total, average and marginal costs of neonatal BSI for the case and control groups from
the perspective of the patients/carers/providers.
Fifty-four percent of the total sample were born with a low birth weight. Neonates with BSI recorded higher costs
compared with neonates without BSI. The highest diference in direct costs was recorded among neonates with extremely low
birth weight (US$732), which is 67% higher than similar neonates without BSI. The regression estimates show a signifcant
correlation between neonatal BSI and LOS in the NICU (p<0.001). Neonates with BSI stayed an additional 10 days in the
NICU compared with their matched cohort. The LOS varies signifcantly depending on the neonate’s weight at birth. The
extra days range from 1 day for neonates defned as macrosomia to 15 extra days for extremely low birth weight neonates.
Neonatal BSI was signifcantly associated with prolonged LOS. The continuous presence of experienced medical staf, as well as parents, to monitor newborns during their stay on the ward has enormous economic burden on both
hospitals and caregivers
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Research Articles