MedERA-Medical Education and Research Alliance, Linwood, NJ, USA, and UMDNJ-University of Medicine and Dentistry of New Jersey , Newark, NJ , USA.
J Med Econ. 2013 Dec;16(12):1399-404. doi: 10.3111/13696998.2013.842922. Epub 2013 Oct 18.
Assessing the costs of healthcare-associated infection (HAI) is challenging. Methodological issues abound. Previous estimates have been derived in diverse ways from varied perspectives in different settings with dissimilar data. RESULTS can be confusing. Full societal costs, which are more inclusive than commonly reported direct hospital costs, have never been fully measured or reported.
To update, combine, and expand previous cost estimates to determine the annual societal burden of illness (direct medical, non-medical, and indirect costs) arising from HAIs in US acute-care hospitals.
The research approach encompassed literature and internet searches; reference identification, selection, and review; then data abstraction, compilation, and analyses to estimate full societal costs. Previously published systemic reviews, surveillance reports, and individual clinical studies, along with newly computed component costs, all contributed to final estimates.
HAIs in US acute-care hospitals lead to direct and indirect costs totaling $96-$147 billion annually. These results are subject to the same limitations as previous studies from which contributing data were derived.
The enormous clinical and economic burden of infection places HAIs high on the list of devastating and costly illnesses, such as cancer, heart attack, stroke, and diabetes, thereby mandating further research and greater efforts to contain a pressing healthcare problem.
评估医疗保健相关感染 (HAI) 的成本具有挑战性。方法学问题比比皆是。以前的估计是从不同的角度在不同的环境中使用不同的数据以不同的方式得出的。结果可能会令人困惑。从未全面衡量或报告过包括更广泛的直接医院成本的全社区成本。
更新、合并和扩展以前的成本估计，以确定美国急性护理医院中由 HAI 引起的疾病年度全社区负担（直接医疗、非医疗和间接成本）。
研究方法包括文献和互联网搜索；参考识别、选择和审查；然后进行数据提取、编译和分析以估算全社区成本。以前发表的系统评价、监测报告和个别临床研究，以及新计算的组成部分成本，都为最终估计做出了贡献。
美国急性护理医院的 HAI 导致每年直接和间接成本总计 960 亿至 1470 亿美元。这些结果与从中得出数据的先前研究存在相同的限制。
感染的巨大临床和经济负担将 HAI 置于癌症、心脏病发作、中风和糖尿病等破坏性和昂贵疾病的前列，因此需要进一步研究和更大的努力来控制这一紧迫的医疗保健问题。
