EVALUATION OF COMMUNITY ACQUIRED PNEUMONIA TREATMENT OUTCOMES AND COST OF ILLNESS AND DEVELOPMENT OF MORTALITY MODEL
| dc.contributor.author | ALI AL-WORAFI, YASER MOHAMMED | |
| dc.date.accessioned | 2016-01-26T08:11:21Z | |
| dc.date.available | 2016-01-26T08:11:21Z | |
| dc.date.issued | 2011-02 | |
| dc.description.abstract | Community acquired pneumonia (CAP) is a major cause of morbidity and mortality worldwide including Malaysia. Identification of the differences in the outcome and ost between a university hospital and a general hospital (GH) could lead to the levelopment of pneumonia interventions and guide the health team to accurately perfonn and administrate health care services effectively. The development and validation of the pneumonia mortality model, which is easily accessible at the time of admission can, identify patients who are at risks, and treat them appropriately. Treatment of CAP is postly and the cost is related to the length of hospital stay (LOS).Therefore, identification of the risk factors of increase the LOS is lead to decrease the cost of CAP treatment. Therefore, this study aims firstly to compare the treatment outcome and cost between a university hospital and a general hospital; secondly, to develop pneumonia mortality model in Hospital Pulau Pinang (HPP) and validation the model in Hospital Universiti 8ains Malaysia(HUSM); thirdly, to identify the risk factors of increase the LOS. A retrospective observational study was conducted among the adult patients with CAP who admitted to the Penang General HPP and to the HUSM from 1st January 2007 to 31 st December 2008. Generally, there is no significant difference between the outcome between the HUSM and HPP. However, there is a significant difference between the cost between the HUSM and HPP. The findings show that the HPP provided a similar treatment outcome at lower CAP treatinent cost in comparison to HUSM. The pneumonia mortality model composed of the following independent variables: confusion, respiratory rate> 30 xxviii Ilthslmin, systolic blood pressure < 90 mmHg, random blood glucose> 13 mmolll, chanica! ventilation, leu admission, concomitant disease more than or equal 3, b < 8 gldl, urea> 11 mmo1ll, albumin < 30 gldl. The model sensitivity is 69.6 %, ecificity is 98.0 %, Positive Predictive Value (pPV) is 83.6 %, Negative Predictive due (NPV) is 95.8 % and area under the curve (AUC) is 0.839. There were the Howing independent risk factors that significantly increase the length of hospital ay; presences of the complications, elderly, presence of the concomitant diseases ssociated with pneumonia, delay administration of antibiotics more than 8 hours and tart the treatment with single antibiotic. It was concluded that the HPP provided a imilar treatment outcome at lower CAP treatment cost in comparison to HUSM. The validated model composed of easily accessible variables at the time of admission can, identify patients who are at risks, and treat them appropriately. | en_US |
| dc.identifier.uri | http://hdl.handle.net/123456789/1710 | |
| dc.subject | ACQIDRED PNEUMONIA | en_US |
| dc.title | EVALUATION OF COMMUNITY ACQUIRED PNEUMONIA TREATMENT OUTCOMES AND COST OF ILLNESS AND DEVELOPMENT OF MORTALITY MODEL | en_US |
| dc.type | Thesis | en_US |
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