Haley R W
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75235.
Am J Med. 1991 Sep 16;91(3B):32S-38S. doi: 10.1016/0002-9343(91)90341-t.
To compete more effectively for resources, it is increasingly important for infection control practitioners to estimate the costs of nosocomial infections and the amount of money their infection control programs save the hospital. Studies on costs should estimate both extra length of stay and extra costs attributable to infectious complications. Cost estimates should either adjust charges by a cost to charge ratio, which is relatively easy, or estimate hospital costs directly by detailed cost-accounting, which is comparatively more difficult. If there is insufficient time to measure costs concurrently in every infected patient, comparative studies can be done by comparing infected and uninfected patients matched on characteristics that control for the preexisting differences between them. Diagnosis-related groups and the number of diagnoses appear to be useful matching variables because they are strongly associated with both nosocomial infection and length of stay. The final results should be expressed as either potential or actual savings to the hospital, depending on whether significant reductions in nosocomial infection rates have been achieved.
为了更有效地竞争资源，感染控制从业人员越来越有必要估算医院感染的成本以及他们的感染控制项目为医院节省的资金数额。成本研究应估算因感染并发症导致的额外住院时间和额外成本。成本估算既可以通过相对简单的成本与收费比率来调整收费，也可以通过详细的成本核算直接估算医院成本，而详细成本核算相对更困难。如果没有足够的时间同时测量每位感染患者的成本，可以通过比较在控制了他们之间预先存在差异的特征上匹配的感染患者和未感染患者来进行对比研究。诊断相关组和诊断数量似乎是有用的匹配变量，因为它们与医院感染和住院时间都密切相关。最终结果应根据是否实现了医院感染率的显著降低，以医院的潜在节省或实际节省来表示。
