Asensio Ángel, Bouza Emilio, Grau Santiago, Rubio-Rodríguez Darío, Rubio-Terrés Carlos
Servicio de Medicina Preventiva, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España.
Rev Esp Salud Publica. 2013 Jan-Feb;87(1):25-33. doi: 10.4321/S1135-57272013000100004.
There are not available adequate studies of the costs of Clostridium difficile-associated diarrhea (CDAD) in Spain. The aim of the study is to estimate the cost of CDAD for the National Health Service (NHS).
an economic model was carried out to calculate the cost per episode of CDAD (due to antimicrobials, prolonged hospitalization, surgical procedures, measures to control the infection, recurrences of infections treated) and the CDAD annual cost. Resources use in clinical practice was obtained through a Delphi panel of Spanish clinicians with expertise in CDAD and unit costs (€ 2012) from Spanish Sources.
An estimated 7,601 episodes of CDAD occur annually in Spain (incidence of 17.1 episodes/year/10,000 hospital discharges) with an annual cost to the NHS of € 32,157,093. Cost per episode of CDAD: € 3,901 (initial infection), € 4,875 (first recurrence) and € 5,916 (second recurrence). Total cost of recurrences: € 10,426,750 annually. The 95.6% of spending is due to the prolonged hospitalization, 0.5% to antibiotic treatment, 2.8% for surgery and 1.1% for measures of control infection. Study results are sensitive to incidence and case fatality rate of CDAD in Spain and the prolongation of duration of hospital stay due to CDAD.
According to this study, the expense associated with CDAD is primarily due to the prolongation of hospitalization and has a great economic impact on the NHS.
西班牙缺乏关于艰难梭菌相关性腹泻(CDAD)成本的充分研究。本研究的目的是估算国家卫生服务体系(NHS)中CDAD的成本。
构建了一个经济模型,以计算CDAD每例发作的成本(因抗菌药物、延长住院时间、外科手术、感染控制措施、治疗感染复发等)以及CDAD的年度成本。临床实践中的资源使用情况通过一个由西班牙CDAD领域专家组成的德尔菲小组获得,单位成本(2012年欧元)来自西班牙的资料来源。
西班牙每年估计发生7601例CDAD(发病率为每年17.1例/10000例出院患者),NHS每年为此花费32157093欧元。CDAD每例发作的成本:初始感染为3901欧元,首次复发为4875欧元,第二次复发为5916欧元。复发的总成本:每年10426750欧元。95.6%的支出是由于延长住院时间,0.5%是由于抗生素治疗,2.8%是由于手术,1.1%是由于感染控制措施。研究结果对西班牙CDAD的发病率和病死率以及CDAD导致的住院时间延长敏感。
根据本研究,与CDAD相关的费用主要是由于住院时间延长,对NHS有重大经济影响。