Abstract Background Addressing the challenges of asthma has involved various approaches, including the examination of costs associated with hospitalization. However, there is a limited number of studies that have investigated the actual expenses incurred by hospital settings in caring for asthma patients. This study aims to describe the costs, predictors, and breakdown of expenditures in different categories. Methods A retrospective cohort study was conducted, involving 314 hospital stays of patients over 12 years old who were admitted for asthma and classified under APR-DRG 141 (asthma). Univariate and multiple linear regression analyses were performed. Results The median cost, regardless of DRG severity, amounted to 2.314€ (1.550€-3.847€). Significant variations were observed when the sample was stratified based on the severity of DRG, revealing a cost gradient that increases with severity. The length of stay followed a similar trend. Six predictors were identified: age, admission to intensive care, asthma severity, severity level of the DRG, winter admission, and length of stay. The cost breakdown showed that 44% constituted direct costs, 25% were indirect costs, 26% were attributed to medical procedures performed outside the patient unit, and 5% were related to medication administration. Conclusions This study initiates a discussion on the role of reducing hospital costs in strategies aiming at controlling asthma-related costs. We argue that cost reduction cannot be achieved solely at the hospital level but must be approached from a public health perspective. This includes promoting high-quality outpatient care and addressing factors leading to poor adherence to the care plan.
ABSTRACT Aim The objectives of this study were to determine the prevalence of burnout risk and intention‐to‐leave among intensive care unit (ICU) nurses and analyse the association of these with workload and work environment. Design A cross‐sectional survey of nurses working in ICUs was conducted in France between 15 January 2024 and 15 April 2024 alongside a longitudinal assessment of workload during the same period. Methods ICU nurse workload was assessed using the Nursing Activities Score (NAS). The risk of burnout was assessed using the Maslach Burnout Inventory scale and intention‐to‐leave the hospital was assessed with a binary question. A total of 1271 nurses working in 61 intensive care units completed the questionnaire and 14,134 NAS per patient and 1885 NAS per nurse were included in the study. Results The median overall of burnout by hospital site was 64.7% [P25: 53.3–P75: 72.7] for the broad definition and a median of 20.7% [13.3–27.3] of ICU nurses reported an intent‐to‐leave their job. The median overall NAS score per nurse was 135.9% [121.4–156.9] and the prevalence of NAS scores exceeding 100% per nurse was 73.9% [62.8–80.3]. A significant association was found between nurses working in an ICU with a better work environment and all dimensions of burnout as well as the intention‐to‐leave the job. A prevalence in the hospital site of NAS scores exceeding 100% per nurse below the median was associated with a lower burnout (OR = 0.69, 95% CI: 0.50–0.88 for broad definition) and intention‐to‐leave the job (OR = 0.68, 95% CI: 0.50–0.92). Conclusion This study found significant associations between burnout and the intention to leave the job for nurses in ICUs, mainly due to a better work environment and, to a lesser extent, a lower workload for nurses. Implications for the Profession and/or Patient Care In an era of nurse shortages and absenteeism, it is crucial for institutions to retain their nursing staff. Our results should encourage hospital managers to take action to improve the ICU work environment and keep ICU workloads manageable to decrease burnout and the intention‐to‐leave the job among ICU nurses. Reporting Method This article follows the STROBE guidelines for the reporting of cross‐sectional studies. Patient or Public Contribution No patient or public contribution.
Our study aimed to assess the severity of severe acute respiratory syndrome coronavirus 2 infection in hospitalized infants under 40 days old, across 21 Belgian hospitals between 2020 and 2022. Of the 365 infants studied, 14.2% needed respiratory support. The median hospital stay was 3 days (interquartile range, 2-4), and there were no deaths. Infection severity was similar during the Omicron and Alpha/Delta periods.
Abstract Background Only one third of European countries use intermediate care units (IMCs). An IMC makes it possible to manage patients who do not require intensive care but who need a higher level of nursing care that cannot be provided on the general ward. In Belgium, there are no national criteria for ICU admission or discharge, and no policies regarding IMC care or for differentiating ICU intensity levels. Aim/s The aim of our study was to analyse the profile of ICU patients in Belgium on the basis of registered nursing activity in order to quantify the number of ICU days potentially transferable to an IMC. Study Design The study was conducted on 310 ICU beds. Patients admitted to the study were recruited during two different one‐month periods in 2018 and were included into a prospective database that evaluated nursing workload carried out in 15 hospitals in the French‐speaking part of Belgium. The number of ICU days that could be supported on an IMC was defined according to the Nursing Activities Score (NAS) items. Results A total of 3279 ICU patients for a total of 13 942 ICU days were included. 4987 days (35.8%) were considered as “transferable” to an IMC. The proportion of ICU days transferable to an IMC was highly variable among hospitals, ranging from 20.4% to 59.5% of all ICU days. On the day of ICU admission, 665/2142 (31.0%) of the patients were already identified as transferable to an IMC; this percentage significantly increased on day 2 (972/2066, 47.1%) and day 3 (650/1390, 46.7%). Conclusions In Belgian ICUs, 35.8% of ICU hospital days, as per recorded NAS, do not necessitate intensive monitoring. These 35.8% of days of ICU hospitalization could be supported on an IMC. Relevance for Clinical Practice In this study, a significant number of days spent in the ICU could be supported on an IMC, this could alleviate the workload of nurses and reduce the occupancy rate of intensive care units.
Le personnel soignant a beaucoup souffert de la crise du COVID-19, et en particulier les infirmiers de soins intensifs. La situation était déjà critique bien avant la pandémie, elle est devenue franchement préoccupante aujourd’hui. L’étude du Centre fédéral d’Expertise des Soins de santé (KCE) publiée aujourd’hui montre que de nombreux infirmiers de soins intensifs sont à la limite du burn-out et envisagent de quitter leur emploi, ou même la profession infirmière. Un bon environnement de travail est un élément essentiel pour retenir dans nos hôpitaux ces professionnels hautement spécialisés et difficilement remplaçables. Le Fonds Blouses blanches a été un premier pas historique pour améliorer leur situation (et celle de la profession infirmière en général) mais il est à présent temps de passer à la vitesse supérieure avec un véritable plan global pour attirer des infirmiers vers les unités de soins intensifs et les motiver à y rester. Ce plan devrait porter, entre autres, sur une meilleure reconnaissance, une rémunération adéquate, une promotion de la formation ainsi qu’une dotation en personnel conforme aux normes internationales.
