1Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention (CDC), Roybal Campus, 1600 Clifton Road MS H16-3, Atlanta, GA 30329-4027 USA.
2Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Roybal Campus, 1600 Clifton Road MS-C25, Atlanta, GA 30329-4027 USA.
Antimicrob Resist Infect Control. 2019 Jan 22;8:17. doi: 10.1186/s13756-018-0459-1. eCollection 2019.
Economic evaluations of interventions to prevent healthcare-associated infections in the United States rarely take the societal perspective and thus ignore the potential benefits of morbidity and mortality risk reductions. Using new Department of Health and Human Services guidelines for regulatory impact analysis, we developed a cost-benefit analyses of a national multifaceted, in-hospital infection prevention program (including staffing an antibiotic stewardship program) that incorporated value of statistical life estimates to obtain economic values associated with morbidity and mortality risk reductions.
We used a net present value model to assess costs and benefits associated with antibiotic stewardship programs. Model inputs included treatment costs, intervention costs, healthcare-associated infection cases, attributable deaths, and the value of statistical life which was used to estimate the economic value of morbidity and mortality risk reductions.
From 2015 to 2020, total net benefits of the intervention to the healthcare system range from $300 million to $7.6 billion when values for morbidity and mortality risk reductions are ignored. Including these values, the net social benefits of the intervention range from $21 billion to $624 billion with the annualized net benefit of $25.5 billion under our most likely outcome scenario.
Incorporating the economic value of morbidity and mortality risk reductions in economic evaluations of healthcare-associated infections will significantly increase the benefits resulting from prevention.
美国预防医疗保健相关性感染的干预措施的经济评估很少从社会角度出发，因此忽略了发病率和死亡率降低带来的潜在益处。我们采用新的美国卫生与公众服务部监管影响分析指南，制定了一项国家多方面住院感染预防计划（包括配备抗生素管理计划人员）的成本效益分析，该计划纳入了统计生命价值估算，以获得与发病率和死亡率降低相关的经济价值。
我们使用净现值模型来评估与抗生素管理计划相关的成本和效益。模型输入包括治疗成本、干预成本、医疗保健相关性感染病例、归因死亡以及统计生命价值，用于估算发病率和死亡率降低带来的经济价值。
从 2015 年到 2020 年，如果忽略发病率和死亡率风险降低的价值，该干预措施对医疗系统的总净效益范围为 3 亿至 76 亿美元。包括这些价值在内，该干预措施的社会净效益范围为 210 亿至 6240 亿美元，在我们最可能出现的结果情景下，年化净效益为 255 亿美元。
在医疗保健相关性感染的经济评估中纳入发病率和死亡率风险降低的经济价值，将显著增加预防带来的收益。
