Costs associated with COVID-19 in healthcare personnel in Greece: a cost-of-illness analysis

BACKGROUND

Healthcare personnel (HCP) are at increased risk of infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the aetiological agent of coronavirus disease 2019 (COVID-19).

AIM

To estimate the costs related to SARS-CoV-2 exposure and infection among HCP in Greece.

METHODS

Data were retrieved from the national database of SARS-CoV-2 infections and from the database of HCP exposed to patients with COVID-19. A cost-of-illness analysis was performed to estimate total, direct and indirect costs.

RESULTS

In total, 254 HCP with COVID-19 and 3332 HCP exposed to patients with COVID-19 during the first epidemic wave were studied. Of the 254 HCP with COVID-19, 49 (19.3%) were hospitalized (mean length of hospitalization 11.6 days) and four were admitted to intensive care units (mean duration 10.8 days). Overall, 1332 (40%) exposed HCP had a mean duration of absenteeism of 7.5 days, and 252 (99.2%) HCP with COVID-19 had a mean duration of absenteeism of 25.8 days. The total costs for the management of the two groups were estimated at €1,735,830 (€772,890 Euros for HCP with COVID-19 and €962,940 for exposed HCP). Absenteeism accounted for a large proportion of the total costs (80.4% of all expenditures), followed by costs for reverse transcriptase polymerase chain reaction and hospitalization (10.2% and 6.5% of all expenditures, respectively).

CONCLUSION

COVID-19 is associated with increased rates and duration of absenteeism among HCP. Indirect costs, particularly absenteeism, are the major driver of total costs among exposed HCP and HCP with COVID-19. The estimated total costs are conservative. Studies are needed to explore the impact of COVID-19 vaccination of HCP on absenteeism and COVID-19-associated costs.

Effectiveness of a preventive bundle of measures for reducing surgical site infections in patients undergoing elective orthopedic procedures in a Hellenic Air Force Hospital

BACKGROUND

Bundles of preventive measures may improve patient outcomes. The aim of this study is to investigate if a surgical site infections (SSIs) preventive bundle in orthopedic surgery patients can result in reduction of such infections, hospitalization length and cost.

METHODS

The present is a retrospective cohort study. A total of 1299 patients was admitted to hospital for an elective orthopedic procedure during 2012-2015. The patients were subjected to either an integrated three-stage SSIs preventive protocol or standard preventive measures. The two groups were compared for incidence of SSIs, median hospitalization length and median cost.

RESULTS

The incidence of SSIs was lower in the new-protocol group, when compared to the old protocol one (p=0.102). Median (md) hospitalization length was significantly lower in the new protocol group (md = 2) compared to "old-protocol" group (md= 5) [U = 280520, p<0.001]. Regarding arthroscopies, the median cost in the new protocol patients (md= 1500) was significantly lower compared to "old-protocol" patients (md= 1585) [(U= 112660), p < 0.001]. Knee arthroplasties' median costs did not differ (both mds= 4400, U = 2002, p > 0.05). For hip arthroplasties, the new protocol's patient median cost (md= 3000) was significantly lower than that of "old-protocol" (md = 4000) [U = 19680, p < 0.001].

CONCLUSIONS

The use of a bundle of measures for the prevention of SSIs in a hospital's orthopedic operations proved effective, since it resulted in substantial decrease of SSIs, statistically significant decreased hospitalization length, as well as cost.

Expectations and perceptions of Greek patients regarding the quality of dental health care

OBJECTIVE

The aim of this study was to investigate the perceptions and expectations of patients regarding the quality of dental health care they received and the criteria they used to select a dentist.

DESIGN

Descriptive study.

METHODS

Two questionnaires referring to the expectations and the perceptions of dental health care were handed to patients. Likert-type scales were used to evaluate the characteristics examined. These characteristics have been classified in four quality dimensions: 'assurance', 'empathy', 'reliability' and 'responsiveness'. STUDY PARTICIPANTS AND SETTING: Two hundred consecutive patients who visited the Dental Clinic of the School of Dentistry, University of Athens, Greece, in 1998-1999.

RESULTS

The patients' top priority was adherence to the rules of antisepsis and sterilization. Women of the middle and lower socio-economic groups were more demanding than men of the same groups, while men of the upper socio-economic group appeared to be more demanding than women (P = 0.02). Their perceptions of the dental service provided reflected their satisfaction regarding the adherence to the rules of antisepsis and sterilization, but also showed their moderate satisfaction regarding most of the other characteristics and their dissatisfaction regarding information on oral health and hygiene.

CONCLUSION

Expectations and demands regarding empathy (approach to the patient) and assurance were placed at the top of the patients' priorities. A highly significant quality gap was observed between the desires of the patients and their perceptions (P< 0.01) and the largest gap was noted concerning information they received about oral health diseases. The largest quality gap was also observed in characteristics regarding responsiveness.

Outbreak of meningococcal disease after an influenza B epidemic at a Hellenic Air Force recruit training center

In January 1996, during an outbreak of meningococcal disease at a Hellenic Air Force recruit center in southern Greece, we collected paired serum specimens from 55 randomly selected recruits and tested for antibodies against influenza virus types A and B. Of 55 specimens, 15 (27%) were found to be positive for recent influenza B infection, confirming previous reports that respiratory tract infection due to influenza is probably a predisposing factor for meningococcal disease.

Cytokines in the treatment of leishmaniasis: from studies of immunopathology to patient therapy

The genus Leishmania, an obligate intramacrophage parasite, causes a wide spectrum of clinical diseases. It is worldwide in distribution and causes 20 million new cases annually with an at risk population of approximately 1.5 billion persons. The most severe forms are associated with high morbidity, mortality and relapses with conventional therapy. The therapeutic issues and responses to standard and alternative therapies are reviewed. Recent developments in molecular biology and immunology methods employed in the study of leishmaniasis have defined an intricate interaction of the parasite with host immune system. Perturbation of the host immune responses may be part of the survival mechanisms of Leishmania. In murine model, the finding of T helper cells that differ by their panel of cytokines has allowed a more precise definition of immunopathogenesis of leishmaniasis. Preliminary data from leishmaniasis patients lend support to this concept of altered immunomodulation. Furthermore, the data from leishmaniasis patients lend support to this concept of altered enhancement of therapeutic response by interferon-gamma has provided a new approach for treatment of patients using recombinant cytokines and for the study of the disease. Current research for early diagnosis, alternative therapies and need for vaccines are reviewed in the context of the immunopathology of leishmaniasis.