Giraldi G, Montesano M, Sandorfi F, Iachini M, Orsi G B
Department of Public Health and Infectious Disease, Sapienza University of Rome, Rome, Italy.
Sant'Andrea Teaching Hospital, Sapienza University of Rome, Rome, Italy.
Ann Ig. 2019 Sep-Oct;31(5):507-516. doi: 10.7416/ai.2019.2311.
Healthcare acquired infections (HAI) cause an increase of burden and in particular excess length of hospital stay (LOS) accounts for approximately up to 90% of total costs. Therefore accurate estimation of extra hospital stay due to healthcare acquired infections is very important.
The authors carried out a review comparing the principal methods internationally used for estimating the excess LOS attributable to healthcare acquired infections.
The methods described and analysed are: 1) Implicit physician assessment; 2) appropriateness evaluation protocol; 3) unmatched case-control; 4) matched case-control; 5) regression analysis; 6) multistate model. The various methodologies are described underlining advantages and limits which researchers need to know before starting any economic analysis.
Overall, studies taking into account the time-dependent nature of HAI show to give more precise and reliable results.
医疗保健相关感染（HAI）会增加负担，特别是住院时间延长（LOS）约占总成本的90%。因此，准确估计医疗保健相关感染导致的额外住院时间非常重要。
作者进行了一项综述，比较了国际上用于估计医疗保健相关感染所致额外住院时间的主要方法。
所描述和分析的方法有：1）医生隐性评估；2）适宜性评估方案；3）非配对病例对照；4）配对病例对照；5）回归分析；6）多状态模型。对各种方法进行了描述，强调了研究人员在开始任何经济分析之前需要了解的优点和局限性。
总体而言，考虑到HAI时间依赖性的研究显示能给出更精确和可靠的结果。
