Mittmann Nicole, Koo Marika, Daneman Nick, McDonald Andrew, Baker Michael, Matlow Anne, Krahn Murray, Shojania Kaveh G, Etchells Edward
Health Outcomes and Pharmaco Economics (HOPE) Research Centre, Division of Clinical Pharmacology, Toronto, ON, Canada.
Drug Healthc Patient Saf. 2012;4:141-65. doi: 10.2147/DHPS.S33288. Epub 2012 Oct 5.
Our objective was to determine the quality of literature in costing of the economic burden of patient safety.
We selected 15 types of patient safety targets for our systematic review. We searched the literature published between 2000 and 2010 using the following terms: "costs and cost analysis," "cost-effectiveness," "cost," and "financial management, hospital." We appraised the methodologic quality of potentially relevant studies using standard economic methods. We recorded results in the original currency, adjusted for inflation, and then converted to 2010 US dollars for comparative purposes (2010 US$1.00 = 2010 €0.76). The quality of each costing study per patient safety target was also evaluated.
We screened 1948 abstracts, and identified 158 potentially eligible studies, of which only 61 (39%) reported any costing methodology. In these 61 studies, we found wide estimates of the attributable costs of patient safety events ranging from $2830 to $10,074. In general hospital populations, the cost per case of hospital-acquired infection ranged from $2132 to $15,018. Nosocomial bloodstream infection was associated with costs ranging from $2604 to $22,414.
There are wide variations in the estimates of economic burden due to differences in study methods and methodologic quality. Greater attention to methodologic standards for economic evaluations in patient safety is needed.
我们的目标是确定有关患者安全经济负担成本核算的文献质量。
我们选择了15种患者安全目标进行系统评价。我们使用以下术语检索了2000年至2010年发表的文献：“成本与成本分析”、“成本效益”、“成本”以及“医院财务管理”。我们使用标准经济方法评估潜在相关研究的方法学质量。我们以原始货币记录结果，并根据通货膨胀进行调整，然后为了比较目的换算成2010年美元（2010年1.00美元 = 2010年0.76欧元）。还对每个患者安全目标的成本核算研究质量进行了评估。
我们筛选了1948篇摘要，确定了158项潜在符合条件的研究，其中只有61项（39%）报告了任何成本核算方法。在这61项研究中，我们发现患者安全事件可归因成本的估计范围很广，从2830美元到10074美元不等。在一般医院人群中，医院获得性感染每例的成本从2132美元到15018美元不等。医院血流感染的相关成本从2604美元到22414美元不等。
由于研究方法和方法学质量的差异，经济负担的估计存在很大差异。需要更加关注患者安全经济评估的方法学标准。
