Rubin R J, Harrington C A, Poon A, Dietrich K, Greene J A, Moiduddin A
Lewin Group, Fairfax, Virginia 22031-1214, USA.
Emerg Infect Dis. 1999 Jan-Feb;5(1):9-17. doi: 10.3201/eid0501.990102.
We modeled estimates of the incidence, deaths, and direct medical costs of Staphylococcus aureus infections in hospitalized patients in the New York City metropolitan area in 1995 by using hospital discharge data collected by the New York State Department of Health and standard sources for the costs of health care. We also examined the relative impact of methicillin-resistant versus -sensitive strains of S. aureus and of community-acquired versus nosocomial infections. S. aureus-associated hospitalizations resulted in approximately twice the length of stay, deaths, and medical costs of typical hospitalizations; methicillin-resistant and -sensitive infections had similar direct medical costs, but resistant infections caused more deaths (21% versus 8%). Community-acquired and nosocomial infections had similar death rates, but community-acquired infections appeared to have increased direct medical costs per patient ($35,300 versus $28,800). The results of our study indicate that reducing the incidence of methicillin-resistant and -sensitive nosocomial infections would reduce the societal costs of S. aureus infection.
我们利用纽约州卫生部收集的医院出院数据以及医疗保健成本的标准来源,对1995年纽约市大都市区住院患者金黄色葡萄球菌感染的发病率、死亡人数和直接医疗成本进行了估算。我们还研究了耐甲氧西林与敏感金黄色葡萄球菌菌株以及社区获得性感染与医院感染的相对影响。与金黄色葡萄球菌相关的住院导致住院时间、死亡人数和医疗成本约为典型住院的两倍;耐甲氧西林和敏感感染的直接医疗成本相似,但耐药感染导致的死亡更多(21%对8%)。社区获得性感染和医院感染的死亡率相似,但社区获得性感染似乎每名患者的直接医疗成本更高(35300美元对28800美元)。我们的研究结果表明,降低耐甲氧西林和敏感医院感染的发病率将降低金黄色葡萄球菌感染的社会成本。