Kurutkan Mehmet Nurullah, Kara Oğuz, Eraslan İsmail Hakki
Management Faculty, Düzce University Turkey.
Int J Clin Exp Med. 2015 Mar 15;8(3):4433-45. eCollection 2015.
Hospital Acquired Infections (HAIs) are defined as infections developing in relation to health services at inpatient treatment facilities in general. Although health services improve, HAIs continue to be seen both in underdeveloped and developed countries. HAIs result in a range of negative externalities. Negative externalities include factors such as an increase in morbidity and mortality, extension of the hospitalization duration, impaired quality of life, loss of working power and performance. HAIs pose a big burden regarding population and community health care. This study aims to calculate the financial burden of HAIs by evaluating it within the scope of negative externality. The communal costs of HAIs patients were calculated by using a genuine approach with reference to samples obtained from the Duzce University Research and Application Hospital. This approach includes 4 stages and the results of each stage is sorted according to the data of 2013 as follows: (i) HAIs expenditure undertaken by the Social Security Institution is 5,832,167 TL, (ii) the monetary value of the work power loss of the HAIs patients who are at a working age is 126,154 TL, (iii) the relative cost of HAIs patients compared to a group of normal patients is 21,507 TL and (iv) HAIs patients' communal cost is 6,013,101 TL. Based on the received results, the annual communal cost of the estimated HAIs patients in Turkey is predicted to be 3,640,442,057 TL. In addition to these findings, HAIs patients experience 14 times longer in-patient stay at the hospitals as compared to normal patients, and their treatment expenditures are 23 times higher than the normal patients. In the conclusion part of the study, regarding the preventability (internalization) of HAIs, which was evaluated as part of negative externality, alternative applicable political suggestions are presented for the use of policymakers.
医院获得性感染（HAIs）通常被定义为在住院治疗机构中与医疗服务相关而发生的感染。尽管医疗服务有所改善，但在发达国家和发展中国家仍能见到医院获得性感染。医院获得性感染会产生一系列负面外部效应。负面外部效应包括发病率和死亡率增加、住院时间延长、生活质量受损、工作能力和表现丧失等因素。医院获得性感染给人群和社区医疗保健带来了沉重负担。本研究旨在通过在负面外部效应范围内对医院获得性感染进行评估来计算其经济负担。参照从杜兹大学研究与应用医院获取的样本，采用一种切实可行的方法计算了医院获得性感染患者的公共成本。该方法包括4个阶段，每个阶段的结果根据2013年的数据进行分类如下：（i）社会保障机构承担的医院获得性感染支出为5,832,167土耳其里拉，（ii）处于工作年龄的医院获得性感染患者工作能力丧失的货币价值为126,154土耳其里拉，（iii）与一组正常患者相比，医院获得性感染患者的相对成本为21,507土耳其里拉，（iv）医院获得性感染患者的公共成本为6,013,101土耳其里拉。根据所得结果，预计土耳其医院获得性感染患者的年度公共成本为3,640,442,057土耳其里拉。除了这些发现外，医院获得性感染患者在医院的住院时间比正常患者长14倍，其治疗费用比正常患者高23倍。在研究的结论部分，针对作为负面外部效应一部分进行评估的医院获得性感染的可预防性（内部化），为政策制定者提供了可供采用的替代政策建议。
