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一家学术医院内两起耐万古霉素肠球菌暴发的成本。

Costs of two vancomycin-resistant enterococci outbreaks in an academic hospital.

作者信息

van der Pol Simon, Lokate Mariëtte, Postma Maarten J, Friedrich Alex W

机构信息

Department of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands.

Health-Ecore, Zeist, The Netherlands.

出版信息

Antimicrob Steward Healthc Epidemiol. 2023 Jan 13;3(1):e8. doi: 10.1017/ash.2022.365. eCollection 2023.

Abstract

OBJECTIVE

In early 2017, the University Medical Center Groningen, the Netherlands, had an outbreak of 2 strains of vancomycin-resistant enterococci (VRE) that spread to various wards. In the summer of 2018, the hospital was again hit by a VRE outbreak, which was detected and controlled early. However, during both outbreaks, fewer patients were admitted to the hospital and various costs were incurred. We quantified the costs of the 2017 and 2018 VRE outbreaks.

DESIGN

Using data from various sources in the hospital and interviews, we identified and quantified the costs of the 2 outbreaks, resulting from tests, closed beds (opportunity costs), cleaning, additional personnel, and patient isolation.

SETTING

The University Medical Center Groningen, an academic hospital in the Netherlands.

RESULTS

The total costs associated with the 2017 outbreak were estimated to be €335,278 (US $356,826); the total costs associated with the 2018 outbreak were estimated at €149,025 (US $158,602).

CONCLUSIONS

The main drivers of the costs were the opportunity costs due to the reduction in admitted patients, testing costs, and cleaning costs. Although the second outbreak was considerably shorter, the costs per day were similar to those of the first outbreak. Major investments are associated with the VRE control measures, and an outbreak of VRE can lead to considerable costs for a hospital. Aggressively screening and isolating patients who may be involved in an outbreak of VRE may reduce the overall costs and improve the continuity of care within the hospital.

摘要

目的

2017年初,荷兰格罗宁根大学医学中心爆发了2株耐万古霉素肠球菌(VRE)疫情,疫情蔓延至各个病房。2018年夏天,该医院再次遭受VRE疫情袭击,但疫情被及早发现并得到控制。然而,在两次疫情期间,入院患者减少,还产生了各种费用。我们对2017年和2018年VRE疫情的成本进行了量化。

设计

利用医院不同来源的数据和访谈,我们识别并量化了两次疫情因检测、床位停用(机会成本)、清洁、额外人员和患者隔离而产生的成本。

地点

荷兰的一家学术医院——格罗宁根大学医学中心。

结果

估计2017年疫情的总成本为335,278欧元(356,826美元);2018年疫情的总成本估计为149,025欧元(158,602美元)。

结论

成本的主要驱动因素是入院患者减少带来的机会成本、检测成本和清洁成本。尽管第二次疫情持续时间短得多,但每天的成本与第一次疫情相似。VRE控制措施需要大量投资,VRE疫情会给医院带来相当大的成本。积极筛查和隔离可能参与VRE疫情的患者,可能会降低总体成本并改善医院内的护理连续性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/15ae/9879878/d88d98aa1e17/S2732494X22003655_fig1.jpg

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