AUTHOR=Hung Trinh Manh , Van Hao Nguyen , Yen Lam Minh , McBride Angela , Dat Vu Quoc , van Doorn H. Rogier , Loan Huynh Thi , Phong Nguyen Thanh , Llewelyn Martin J. , Nadjm Behzad , Yacoub Sophie , Thwaites C. Louise , Ahmed Sayem , Van Vinh Chau Nguyen , Turner Hugo C. , The Vietnam ICU Translational Applications Laboratory (VITAL) Investigators , Thao Dang Phuong , Kien Dang Trung , Thy Doan Bui Xuan , Trinh Dong Huu Khanh , Duc Du Hong , Geskus Ronald , Hai Ho Bich , Chanh Ho Quang , Hien Ho Van , Trieu Huynh Trung , Kestelyn Evelyne , Khoa Le Dinh Van , Phuong Le Thanh , Tran Luu Hoai Bao , An Luu Phuoc , Mcbride Angela , Vuong Nguyen Lam , Huy Nguyen Quang , Quyen Nguyen Than Ha , Ngoc Nguyen Thanh , Giang Nguyen Thi , Thanh Nguyen Thi Le , Dung Nguyen Thi Phuong , Thao Nguyen Thi Phuong , Van Ninh Thi Thanh , Khanh Phan Nguyen Quoc , Lam Phung Khanh , Nhat Phung Tran Huy , Thwaites Guy , Duc Tran Minh , Nuil Jennifer Ilo Van , Huyen Vu Ngo Thanh , Tam Cao Thi , Thuy Duong Bich , Duong Ha Thi Hai , Nghia Ho Dang Trung , Chau Le Buu , Toan Le Mau , Thu Le Ngoc Minh , Thao Le Thi Mai , Tai Luong Thi Hue , Phu Nguyen Hoan , Viet Nguyen Quoc , Nguyen Nguyen Thanh , Anh Nguyen Thi Kim , Duoc Nguyen Van Thanh , Oanh Pham Kieu Nguyet , Van Phan Thi Hong , Qui Phan Tu , Tho Phan Vinh , Thao Truong Thi Phuong , Ali Natasha , Clifton David , English Mike , Ghiasi Shadi , Greeff Heloise , Hagenah Jannis , Lu Ping , McKnight Jacob , Paton Chris , Georgiou Pantelis , Perez Bernard Hernandez , Hill-Cawthorne Kerri , Holmes Alison , Karolcik Stefan , Ming Damien , Moser Nicolas , Canas Liane , Gomez Alberto , Kerdegari Hamideh , Modat Marc , Razavi Reza , Denehy Linda , Pisani Luigi , Schultz Marcus TITLE=Direct Medical Costs of Tetanus, Dengue, and Sepsis Patients in an Intensive Care Unit in Vietnam JOURNAL=Frontiers in Public Health VOLUME=10 YEAR=2022 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.893200 DOI=10.3389/fpubh.2022.893200 ISSN=2296-2565 ABSTRACT=Background

Critically 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.

Methods

We 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.

Results

ICU 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.

Conclusion

This 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.