Plowman R, Graves N, Griffin M A, Roberts J A, Swan A V, Cookson B, Taylor L
Infection Control Unit, Laboratory of Hospital Infection, Central Public Health Laboratory, London, UK.
J Hosp Infect. 2001 Mar;47(3):198-209. doi: 10.1053/jhin.2000.0881.
Between April 1994 and May 1995 4000 adult patients admitted to selected specialties of a district general hospital were recruited to this study. Hospital-acquired infections presenting during the in-patient stay were identified using previously validated methods of surveillance, and information on daily resource use by both infected and uninfected patients was recorded and estimates of their cost derived. Linear regression modelling techniques were used to estimate how much of the observed variation in resource use and costs could be explained by the presence of an infection. Complete in-patient data sets were obtained for 3980 patients. Of these, 309 patients (7.8%; 95% CI; 7.0, 8.6) presented with one or more hospital-acquired infections during the in-patient period. Infected patients, on average, incurred hospital costs 2.9 (regression model estimate: 2.8; 95% CI; 2.6, 3.0) times higher than uninfected patients, equivalent to an additional pound3154 (regression model estimate pound2917). Both the incidence and the economic impact varied with site of infection and with admission specialty. Estimates of the burden of hospital-acquired infections occurring in adult patients admitted to similar specialties at NHS hospitals in England were derived from the results of this study. An estimated 320 994 (95% CI; 288 071, 353 916) patients per annum acquire one or more infections which present during the in-patient period, and these infections cost the hospital sector an estimated 930.62 million pounds (95% CI; 780.26 pounds; 1080.97 million pounds) per annum. The results presented represent the gross economic benefits that might accrue if these infections are prevented. Further research is required to establish the net benefits of prevention.
1994年4月至1995年5月期间,选取了一家地区综合医院的特定专科收治的4000名成年患者参与本研究。采用先前验证过的监测方法识别住院期间发生的医院获得性感染,并记录感染患者和未感染患者的每日资源使用信息,并得出其成本估算值。使用线性回归建模技术来估算感染的存在能在多大程度上解释观察到的资源使用和成本差异。获得了3980名患者完整的住院数据集。其中,309名患者(7.8%;95%置信区间:7.0,8.6)在住院期间出现了一种或多种医院获得性感染。感染患者的住院费用平均比未感染患者高2.9倍(回归模型估算值:2.8;95%置信区间:2.6,3.0),相当于额外增加3154英镑(回归模型估算值2917英镑)。感染发生率和经济影响均因感染部位和入院专科而异。根据本研究结果得出了在英格兰国民健康服务体系(NHS)医院类似专科收治的成年患者中发生医院获得性感染的负担估算值。估计每年有320994名(95%置信区间:288071,353916)患者在住院期间获得一种或多种感染,这些感染每年给医院部门造成的估计成本为9.3062亿英镑(95%置信区间:7.8026亿英镑;10.8097亿英镑)。所呈现的结果代表了如果预防这些感染可能产生的总体经济效益。需要进一步研究以确定预防的净效益。