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德国养老院中多重耐药菌的经济负担:基于实证数据的成本分析

Economic burden of multidrug-resistant bacteria in nursing homes in Germany: a cost analysis based on empirical data.

作者信息

Huebner Claudia, Roggelin Marcus, Flessa Steffen

机构信息

Institute of Health Care Management, University of Greifswald, Greifswald, Germany.

出版信息

BMJ Open. 2016 Feb 23;6(2):e008458. doi: 10.1136/bmjopen-2015-008458.

Abstract

OBJECTIVES

Infections and colonisations with multidrug-resistant organisms (MDROs) increasingly affect different types of healthcare facilities worldwide. So far, little is known about additional costs attributable to MDROs outside hospitals. The aim of this study was to analysis the economic burden of multidrug-resistant bacteria in nursing homes in Germany.

SETTING

The cost analysis is performed from a microeconomic perspective of the healthcare facilities. Study took place in six long-term care facilities in north-eastern Germany.

PARTICIPANTS

Data of 71 residents with a positive MDRO status were included.

PRIMARY AND SECONDARY OUTCOME MEASURES

The study analysed MDRO surveillance data from 2011 to 2013. It was supplemented by an empirical analysis to determine the burden on staff capacity and materials consumption.

RESULTS

11,793 days with a positive multidrug-resistant pathogen diagnosis could be included in the analysis. On average, 11.8 (SD ± 6.3) MDRO cases occurred per nursing home. Mean duration per case was 163.3 days (SD ± 97.1). The annual MDRO-related costs varied in nursing homes between €2449.72 and €153,263.74 on an average €12,682.23 per case. Main cost drivers were staff capacity (€43.95 per day and €7177.04 per case) and isolation materials (€24.70 per day and €4033.51 per case).

CONCLUSIONS

The importance of MDROs in nursing homes could be confirmed. MDRO-related cost data in this specific healthcare sector were collected for the first time. Knowledge about the burden of MDROs will enable to assess the efficiency of hygiene intervention measures in nursing homes in the future.

摘要

目的

耐多药微生物(MDROs)引起的感染和定植日益影响着全球不同类型的医疗机构。到目前为止,对于医院以外因MDROs产生的额外成本知之甚少。本研究的目的是分析德国养老院中耐多药细菌的经济负担。

背景

成本分析是从医疗机构的微观经济角度进行的。研究在德国东北部的六家长期护理机构开展。

参与者

纳入了71名MDRO检测呈阳性的居民的数据。

主要和次要观察指标

本研究分析了2011年至2013年的MDRO监测数据。并通过实证分析补充,以确定对 staff capacity(人员能力)和材料消耗的负担。

结果

11793天耐多药病原体诊断呈阳性可纳入分析。每个养老院平均发生11.8例(标准差±6.3)MDRO病例。每例的平均持续时间为163.3天(标准差±97.1)。养老院中每年与MDRO相关的成本在2449.72欧元至153263.74欧元之间,平均每例为12682.23欧元。主要成本驱动因素是人员能力(每天43.95欧元,每例7177.04欧元)和隔离材料(每天24.70欧元,每例4033.51欧元)。

结论

可以证实MDROs在养老院中的重要性。首次收集了这个特定医疗部门中与MDRO相关的成本数据。关于MDROs负担的知识将有助于未来评估养老院中卫生干预措施的效率。

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