Feenstra, J.A. (Jerryt) (2018) Kosteneffectiviteitsanalyse van chloorhexidinegebruik op de Intensive Care ter voorkoming van pneumonieën. thesis, Dentistry.
Full text available on request.Abstract
Background: Patients admitted to the Intensive Care Units (ICU) of hospitals are known to have an increasing risk of developing a Ventilator Associated Pneumonia (VAP).1 VAP is one of the most prevalent nosocomial infection diseases.3 Caused by the aspiration of commensal oral bacteria and a less functioning immune system, VAP is being associated with a high mortality and lower surviving rates in five years.8,13,15 It is known that rinsing with a Chlorhexidine mouthwash can reduce the number of oral bacteria increasingly, which may lead to a decreasing number of patients developing VAPs on the ICU.30-31 The research question was as follow: “Is rinsing with chlorhexidine on the ICU a cost-effective measure to prevent patients from developing VAP?” Methods: PubMed and EMBASE databases were systematically searched using the following keywords: “Ventilator Associated Pneumonia, Community-Acquired Pneumonia, cost-effectiveness, Chlorhexidine, Pneumonia, Intensive Care Unit, Quality Adjusted Life Years”. Additional information was gathered from the foundation National Intensive Care Evaluation, Health Institution Netherlands, medical specialists and hospital pharmacists. A cohort of 85.000 patients representing the Netherlands and a cohort of 3.500 patients representing the University Medical Center Groningen were used to for the purpose of this study. Results: The base case for the incremental cost effectiveness ratio is € 6.698 per QALY gained. This is below the benchmark of € 20.000 per QALY.32 Both probabilistic and deterministic sensitivity analyses showed robustness of the incremental cost-effectiveness ratios (ICERs). Additionally, the intervention can be regarded cost-saving when the nurse costs are not included in the base case, a negative ICER of € 148 per QALY gained was found. Conclusions: Mouth rinsing with chlorhexidine against VAP in patients, admitted to the ICU can be regarded a cost-effective measure for Dutch hospitals. Keywords: Ventilator Associated Pneumonia, Community-Acquired Pneumonia, cost-effectiveness, Chlorhexidine, Pneumonia, Intensive Care Unit, Quality Adjusted Life Years.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Postma, Prof. dr. M.J. and Vermaire, dr. J.H. and Sluis, dr. L. W. M. van der |
| Faculty: | Medical Sciences |
| Date Deposited: | 18 Nov 2021 11:23 |
| Last Modified: | 22 Nov 2021 11:25 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2801 |
Actions (login required)
 |
View Item |