Análisis y costo de infección asociada a catéter venoso central en el Hospital Militar Central con utilización de herramienta de Health Analytics

Introducción: Las infecciones asociadas a catéter venoso central (IACVC) se encuentran dentro de las patologías que aumentan la mortalidad y morbilidad en pacientes hospitalizados con algún tipo de dispositivo, estando consideradas como parte los indicadores de gestión clínica. Objetivo: Describir l...

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Autores:
Gomez Boada, Diego Fernando
Parra Amaris, Camilo Andres
Tipo de recurso:
Trabajo de grado de pregrado
Fecha de publicación:
2021
Institución:
Universidad Militar Nueva Granada
Repositorio:
Repositorio UMNG
Idioma:
spa
OAI Identifier:
oai:repository.unimilitar.edu.co:10654/37418
Acceso en línea:
http://hdl.handle.net/10654/37418
Palabra clave:
Central venous catheter-associated infection
Direct costs
Catheter-associated bacteraemia
Health related infection
Cateterismo Venoso Central
Infecciones Relacionadas con Catéteres
Infección Hospitalaria
Control de Infecciones
Infección asociada a catéter venoso central
Costos directos
Bacteriemia asociada a catéter
Infección relacionada con el cuidado de la salud
Rights
openAccess
License
http://creativecommons.org/licenses/by-nc-nd/4.0/
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dc.title.spa.fl_str_mv Análisis y costo de infección asociada a catéter venoso central en el Hospital Militar Central con utilización de herramienta de Health Analytics
dc.title.translated.spa.fl_str_mv Analysis and cost of infection associated with a central venous catheter in the Central Military Hospital using the Health Analytics tool
title Análisis y costo de infección asociada a catéter venoso central en el Hospital Militar Central con utilización de herramienta de Health Analytics
spellingShingle Análisis y costo de infección asociada a catéter venoso central en el Hospital Militar Central con utilización de herramienta de Health Analytics
Central venous catheter-associated infection
Direct costs
Catheter-associated bacteraemia
Health related infection
Cateterismo Venoso Central
Infecciones Relacionadas con Catéteres
Infección Hospitalaria
Control de Infecciones
Infección asociada a catéter venoso central
Costos directos
Bacteriemia asociada a catéter
Infección relacionada con el cuidado de la salud
title_short Análisis y costo de infección asociada a catéter venoso central en el Hospital Militar Central con utilización de herramienta de Health Analytics
title_full Análisis y costo de infección asociada a catéter venoso central en el Hospital Militar Central con utilización de herramienta de Health Analytics
title_fullStr Análisis y costo de infección asociada a catéter venoso central en el Hospital Militar Central con utilización de herramienta de Health Analytics
title_full_unstemmed Análisis y costo de infección asociada a catéter venoso central en el Hospital Militar Central con utilización de herramienta de Health Analytics
title_sort Análisis y costo de infección asociada a catéter venoso central en el Hospital Militar Central con utilización de herramienta de Health Analytics
dc.creator.fl_str_mv Gomez Boada, Diego Fernando
Parra Amaris, Camilo Andres
dc.contributor.advisor.none.fl_str_mv Uscategui Ruiz, Adriana Catalina
Carreño Jaimes, Marisol
dc.contributor.author.none.fl_str_mv Gomez Boada, Diego Fernando
Parra Amaris, Camilo Andres
dc.subject.keywords.spa.fl_str_mv Central venous catheter-associated infection
Direct costs
Catheter-associated bacteraemia
Health related infection
topic Central venous catheter-associated infection
Direct costs
Catheter-associated bacteraemia
Health related infection
Cateterismo Venoso Central
Infecciones Relacionadas con Catéteres
Infección Hospitalaria
Control de Infecciones
Infección asociada a catéter venoso central
Costos directos
Bacteriemia asociada a catéter
Infección relacionada con el cuidado de la salud
dc.subject.decs.spa.fl_str_mv Cateterismo Venoso Central
Infecciones Relacionadas con Catéteres
Infección Hospitalaria
Control de Infecciones
dc.subject.proposal.spa.fl_str_mv Infección asociada a catéter venoso central
Costos directos
Bacteriemia asociada a catéter
Infección relacionada con el cuidado de la salud
description Introducción: Las infecciones asociadas a catéter venoso central (IACVC) se encuentran dentro de las patologías que aumentan la mortalidad y morbilidad en pacientes hospitalizados con algún tipo de dispositivo, estando consideradas como parte los indicadores de gestión clínica. Objetivo: Describir las características de la infección asociada a catéter venoso central y los costos directos asociados a la misma en el Hospital Militar Central utilizando una herramienta de Health Anlytics en el periodo 2017 hasta el 2020. Metodología: Estudio de evaluación económica, estimación de costos directos relacionados con la infección asociada a CVC. Se utilizo la metodología de costos directos, por medio de la revisión de registros médicos electrónicos con estimación de costos de acuerdo con las recomendaciones del IETS. Análisis estadístico bivariado para identificar diferencias estadísticamente significativas Resultados: La población incluida para el análisis fue un total de 821 CVC entre 2017 y 2020. En relación con el análisis bivariado se identificaron diferencias estadísticamente significativas en el caso sexo, edad, frecuencia de comorbilidades, especialidad tratante, numero de vías del CVC, sitio de inserción, profesional a cargo de inserción, lugar del procedimiento, duración en días del CVC, tiempo de hospitalización, tiempo de estancia en hospitalización convencional, tiempo de estancia en Unidad de Cuidado Intensivo, uso de Ventilacion Mecanica Invasiva, uso de Ventilacion Mecanica No Invasiva, uso de Nutricion Parenteral Total, uso de Antibiotico, uso de Terapia de reemplazo renal. Para el análisis de costos directos a nivel hospitalario se identificó un costo total en lo pacientes sin diagnóstico de infección CVC fue de $31.822.751 COP (RIC $16.772.009-69.038.536 COP). Se identificó una diferencia estadísticamente significativa entre los pacientes con infección asociada al CVC comparado con aquellos pacientes sin infección para los casos de costos asociados a hospitalización (p=0,013), a procedimientos (p=0,0002), a imágenes diagnosticas (p=0,061), a terapia de reemplazo renal (p=0,0003) y costos totales (p=0,028). Conclusiones El presente estudio permite confirmar hallazgos previamente descritos en nuestra institución de una frecuencia similar de IACVC al compararse con reportes nacionales y mayor en comparación con lo repostado por literatura anglosajona, así mismo permite confirmar el incremento de los costos directos asociados a la presencia de IACVC, en donde se evidencia un incremento en los costos asociados a hospitalización, a procedimientos, a imágenes diagnosticas, a terapia de reemplazo renal y costos totales de forma estadísticamente significativa.
publishDate 2021
dc.date.accessioned.none.fl_str_mv 2021-02-22T16:28:44Z
dc.date.available.none.fl_str_mv 2021-02-22T16:28:44Z
dc.date.issued.none.fl_str_mv 2021-01-28
dc.type.local.spa.fl_str_mv Tesis/Trabajo de grado - Monografía - Especialización
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/bachelorThesis
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dc.identifier.instname.spa.fl_str_mv instname:Universidad Militar Nueva Granada
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional Universidad Militar Nueva Granada
dc.identifier.repourl.spa.fl_str_mv repourl:https://repository.unimilitar.edu.co
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identifier_str_mv instname:Universidad Militar Nueva Granada
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dc.language.iso.spa.fl_str_mv spa
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Cohen ER, Feinglass J, Barsuk JH, Barnard C, O’Donnell A, McGaghie WC, et al. Cost savings from reduced catheter-related bloodstream infection after simulation-based education for residents in a medical intensive care unit. Simul Healthc. 2010;5(2):98–102
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Cicalini S, Palmieri F, Petrosillo N. Clinical review: New technologies for prevention of intravascular catheter-related infections. Crit Care. 2004;8(3):157–62
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Maenthaisong R, Chaiyakunapruk N, Thamlikitkul V. Cost-effectiveness analysis of chlorhexidine gluconate compared with povidone-iodine solution for catheter-site care in Siriraj Hospital, Thailand. J Med Assoc Thail. 2006;89(SUPPL. 5):94–101.
Fraher MH, Collins CJ, Bourke J, Phelan D, Lynch M. Cost-effectiveness of employing a total parenteral nutrition surveillance nurse for the prevention of catheter-related bloodstream infections. J Hosp Infect. 2009;73(2):129–34.
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spelling Uscategui Ruiz, Adriana CatalinaCarreño Jaimes, MarisolGomez Boada, Diego FernandoParra Amaris, Camilo AndresEspecialista en Medicina InternaHospital Militar Central, Bogota, Colombia2017-2020Medicina2021-02-22T16:28:44Z2021-02-22T16:28:44Z2021-01-28http://hdl.handle.net/10654/37418instname:Universidad Militar Nueva Granadareponame:Repositorio Institucional Universidad Militar Nueva Granadarepourl:https://repository.unimilitar.edu.coIntroducción: Las infecciones asociadas a catéter venoso central (IACVC) se encuentran dentro de las patologías que aumentan la mortalidad y morbilidad en pacientes hospitalizados con algún tipo de dispositivo, estando consideradas como parte los indicadores de gestión clínica. Objetivo: Describir las características de la infección asociada a catéter venoso central y los costos directos asociados a la misma en el Hospital Militar Central utilizando una herramienta de Health Anlytics en el periodo 2017 hasta el 2020. Metodología: Estudio de evaluación económica, estimación de costos directos relacionados con la infección asociada a CVC. Se utilizo la metodología de costos directos, por medio de la revisión de registros médicos electrónicos con estimación de costos de acuerdo con las recomendaciones del IETS. Análisis estadístico bivariado para identificar diferencias estadísticamente significativas Resultados: La población incluida para el análisis fue un total de 821 CVC entre 2017 y 2020. En relación con el análisis bivariado se identificaron diferencias estadísticamente significativas en el caso sexo, edad, frecuencia de comorbilidades, especialidad tratante, numero de vías del CVC, sitio de inserción, profesional a cargo de inserción, lugar del procedimiento, duración en días del CVC, tiempo de hospitalización, tiempo de estancia en hospitalización convencional, tiempo de estancia en Unidad de Cuidado Intensivo, uso de Ventilacion Mecanica Invasiva, uso de Ventilacion Mecanica No Invasiva, uso de Nutricion Parenteral Total, uso de Antibiotico, uso de Terapia de reemplazo renal. Para el análisis de costos directos a nivel hospitalario se identificó un costo total en lo pacientes sin diagnóstico de infección CVC fue de $31.822.751 COP (RIC $16.772.009-69.038.536 COP). Se identificó una diferencia estadísticamente significativa entre los pacientes con infección asociada al CVC comparado con aquellos pacientes sin infección para los casos de costos asociados a hospitalización (p=0,013), a procedimientos (p=0,0002), a imágenes diagnosticas (p=0,061), a terapia de reemplazo renal (p=0,0003) y costos totales (p=0,028). Conclusiones El presente estudio permite confirmar hallazgos previamente descritos en nuestra institución de una frecuencia similar de IACVC al compararse con reportes nacionales y mayor en comparación con lo repostado por literatura anglosajona, así mismo permite confirmar el incremento de los costos directos asociados a la presencia de IACVC, en donde se evidencia un incremento en los costos asociados a hospitalización, a procedimientos, a imágenes diagnosticas, a terapia de reemplazo renal y costos totales de forma estadísticamente significativa.1. RESUMEN 4 2. INTRODUCCIÓN 7 3. MARCO TEÓRICO 9 4. IDENTIFICACIÓN Y FORMULACIÓN DEL PROBLEMA 19 4.1. PREGUNTA DE INVESTIGACIÓN 20 5. OBJETIVOS E HIPÓTESIS 21 5.1. GENERAL 21 5.2. ESPECÍFICOS 21 6. METODOLOGÍA 22 6.1 Tipo y diseño general del estudio 22 6.2 Lugar de la investigación 22 6.3 Población 22 6.3.1. Población Blanco 22 6.3.2. Población Referencia 22 6.3.3. Población estudio 22 6.4 Criterios de inclusión y exclusión 22 6.4.1 Criterios de inclusión 22 6.4.2 Criterios de exclusión 23 6.5 Selección y tamaño de muestra 23 6.5.1. Muestreo 23 6.5.2. Tamaño de la muestra 23 6.6 Definición de las variables 24 6.7. Estudios de intervención 26 6.8. Estrategias para suprimir amenazas a la validez de resultados 26 6.9. Plan de recolección de datos 27 6.10. Plan de análisis 27 7. ASPECTOS ÉTICOS 29 8. RESULTADOS 30 9. DISCUSIÓN 38 10. CONCLUSIONES 43 11. REFERENCIAS BIBLIOGRÁFICAS 44Introduction: Central venous catheter-associated infections (CVCAI) are among the pathologies that increase mortality and morbidity in patients hospitalized with some type of device, being considered as part of the clinical management indicators. Objective: To describe characteristics of CVCAI and the direct costs associated with them in the Central Military Hospital using a Health Analysis tool in the period 2017 to 2020. Methodology: Economic evaluation study, estimation of direct costs related to CVCAI. The direct costs methodology was used, through the review of electronic medical records with cost estimates in accordance with the IETS recommendations. Bivariate statistical analysis was used to identify statistically significant differences. Results: The population included for the analysis was a total of 821 CVC between 2017 and 2020. Statistically significant differences were identified for sex, age, comorbidities, treating specialty, number of CVC routes, site of insertion, professional in charge of insertion, place of the procedure, duration of CVC, hospitalization length, use of Invasive Mechanical Ventilation, use of Non Invasive Mechanical Ventilation, use of Total Parenteral Nutrition, use of Antibiotics, use of renal replacement therapy. For the analysis of direct costs at the hospital level, a total cost in patients without a diagnosis of CVC infection was identified as $ 31,822,751 COP (IQR $ 16,772,009-69,038,536 COP). A statistically significant difference was identified between patients with CVCAI compared to patients without infection for cases of costs associated with hospitalization (p = 0.013), procedures (p = 0.0002), diagnostic images (p = 0.061), renal replacement therapy (p = 0.0003), and total costs (p = 0.028). Conclusions The present study allows us to confirm findings previously described in our institution of a similar frequency of CVCIA when compared with national reports and higher compared to that reported by Anglo-Saxon literature, likewise it allows confirming the increase in direct costs associated with the presence of CVCIA, where an increase in costs associated with hospitalization, procedures, diagnostic images, renal replacement therapy and total costs is evidenced in a statistically significant way.Especializaciónapplicaction/pdfspahttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 InternationalAcceso abiertoAnálisis y costo de infección asociada a catéter venoso central en el Hospital Militar Central con utilización de herramienta de Health AnalyticsAnalysis and cost of infection associated with a central venous catheter in the Central Military Hospital using the Health Analytics toolTesis/Trabajo de grado - Monografía - Especializacióninfo:eu-repo/semantics/bachelorThesishttp://purl.org/coar/resource_type/c_7a1fCentral venous catheter-associated infectionDirect costsCatheter-associated bacteraemiaHealth related infectionCateterismo Venoso CentralInfecciones Relacionadas con CatéteresInfección HospitalariaControl de InfeccionesInfección asociada a catéter venoso centralCostos directosBacteriemia asociada a catéterInfección relacionada con el cuidado de la saludMedicina InternaFacultad de MedicinaUniversidad Militar Nueva GranadaHajjej Z, Nasri M, Sellami W, Gharsallah H, Labben I, Ferjani M. 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Am J Infect Control. 2004 Dec;32(8):470–85THUMBNAILGomezBoadaDiegoFernandoParraAmarisCamiloAndres2021.pdf.jpgGomezBoadaDiegoFernandoParraAmarisCamiloAndres2021.pdf.jpgIM Thumbnailimage/jpeg6427http://repository.unimilitar.edu.co/bitstream/10654/37418/4/GomezBoadaDiegoFernandoParraAmarisCamiloAndres2021.pdf.jpg1ff404f81b596f2303b560f45898eafbMD54GomezBoadaDiegoFernandoParraAmarisCamiloAndres2021_Anexo.pdf.jpgGomezBoadaDiegoFernandoParraAmarisCamiloAndres2021_Anexo.pdf.jpgIM Thumbnailimage/jpeg7082http://repository.unimilitar.edu.co/bitstream/10654/37418/5/GomezBoadaDiegoFernandoParraAmarisCamiloAndres2021_Anexo.pdf.jpg5cbbdf8a7208efa7a8fba3bfd50af238MD55ORIGINALGomezBoadaDiegoFernandoParraAmarisCamiloAndres2021.pdfGomezBoadaDiegoFernandoParraAmarisCamiloAndres2021.pdfTesisapplication/pdf514049http://repository.unimilitar.edu.co/bitstream/10654/37418/1/GomezBoadaDiegoFernandoParraAmarisCamiloAndres2021.pdfbab0d8e83d1daf5947392af4869b9730MD51GomezBoadaDiegoFernandoParraAmarisCamiloAndres2021_Anexo.pdfGomezBoadaDiegoFernandoParraAmarisCamiloAndres2021_Anexo.pdfapplication/pdf90990http://repository.unimilitar.edu.co/bitstream/10654/37418/2/GomezBoadaDiegoFernandoParraAmarisCamiloAndres2021_Anexo.pdff1a521a233f843ecafca8bf534d96fbcMD52LICENSElicense.txtlicense.txttext/plain; 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