德国一家大学医院因医疗保健相关感染导致的住院时间延长及费用增加情况。

Extra length of stay and costs because of health care-associated infections at a German university hospital.

作者信息

Arefian Habibollah, Hagel Stefan, Heublein Steffen, Rissner Florian, Scherag André, Brunkhorst Frank Martin, Baldessarini Ross J, Hartmann Michael

机构信息

Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany; Hospital Pharmacy, Jena University Hospital, Jena, Germany.

Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany; Center for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany; Department of Internal Medicine IV, Jena University Hospital, Jena, Germany.

出版信息

Am J Infect Control. 2016 Feb;44(2):160-6. doi: 10.1016/j.ajic.2015.09.005.

DOI:10.1016/j.ajic.2015.09.005

PMID:26521700

Abstract

BACKGROUND

Health care-associated infections (HAIs) can be associated with increased health care costs. We examined extra length of hospital stay (LOS) and associated per diem costs attributable to HAIs in a large academic medical center.

METHODS

Data for analysis were acquired in a preinterventional phase of a prospective cohort study (ALERTS) conducted over 12 months in 27 general and 4 intensive care units at Jena University Hospital. HAIs were identified among patients hospitalized for ≥48 hours with at least 1 risk factor for HAI and new antimicrobial therapy; the diagnosis was confirmed by U.S. Centers for Disease Control and Prevention criteria. Extra LOS was estimated by multistate modeling, and associated extra costs were based on average per diem costs for clinical units sampled.

RESULTS

Of a total of 22,613 patients hospitalized for ≥48 hours, 893 (3.95%) experienced 1,212 episodes of HAI during 12 months. The associated mean extra LOS ± SEM in general units was 8.45 ± 0.80 days per case and 8.09 ± 0.91 days for patients treated in both general and intensive care units. Additional costs attributable to HAIs were €5,823-€11,840 ($7,453-$15,155) per infected patient.

CONCLUSION

HAIs generated substantial extra costs by prolonging hospitalization. Potential clinical and financial savings may be realized by implementing effective infection prevention programs.

摘要

背景

医疗保健相关感染（HAIs）可能会增加医疗保健成本。我们在一家大型学术医疗中心研究了因HAIs导致的额外住院时间（LOS）及相关每日费用。

方法

分析数据来自于一项前瞻性队列研究（ALERTS）的干预前阶段，该研究在耶拿大学医院的27个普通病房和4个重症监护病房进行了12个月。在住院≥48小时且至少有1个HAI危险因素及新抗菌治疗的患者中识别出HAIs；诊断依据美国疾病控制与预防中心的标准确定。通过多状态建模估计额外住院时间，相关额外费用基于所抽取临床科室的平均每日费用。

结果

在总共22,613名住院≥48小时的患者中，893名（3.95%）在12个月内发生了1,212次HAI发作。普通病房相关的平均额外住院时间±标准误为每例8.45±0.80天，在普通病房和重症监护病房接受治疗的患者为8.09±0.91天。每位感染患者因HAIs产生的额外费用为5,823 - 11,840欧元（7,453 - 15,155美元）。