Center for Economic and Social Studies in Health, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
Subdirector Comprehensive Patient Attention, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
Front Public Health. 2023 Mar 9;11:1117680. doi: 10.3389/fpubh.2023.1117680. eCollection 2023.
An automated hand-hygiene monitoring system (AHHMS) was implemented in October 2019 at the (HIMFG), a tertiary pediatric referral hospital, in four of the hospital wards with the highest rates of Healthcare Associated Infections (HAIs). The clinical and economic impact of this system had not yet been assessed prior to this study. This study aimed to evaluate if the AHHMS is a cost-effective alternative in reducing HAIs in the HIMFG.
A full cost-effectiveness economic assessment was carried out for the hospital. The alternatives assessed were AHHMS implementation AHHMS non-implementation (historical tendency). The outcomes of interest were infection rate per 1,000 patient-days and cost savings as a result of prevented infections. Infection rate data per 1,000 patient-days (PD) were obtained from the hospital's Department of Epidemiology with respect to the AHHMS. As regards historical tendency, an infection-rate model was designed for the most recent 6-year period. Infection costs were obtained from a review of available literature on the subject, and the cost of the implemented AHHMS was provided by the hospital. The assessment period was 6 months. The incremental cost-effectiveness ratio was estimated. Costs are reported in US Dollars (2021). Univariate sensitivity and threshold analysis for different parameters was conducted.
The total estimated cost of the AHHMS alternative represented potential savings of $308,927-$546,795 US Dollars compared to non-implementation of the system (US$464,102 v. US$773,029-$1,010,898) for the period. AHHMS effectiveness was reflected in a diminished number of infections, 46-79 (-43.4-56.7%) compared to non-implementation (60 v. 106-139 infections).
The AHHMS was found to be a cost-saving alternative for the HIMFG given its cost-effectiveness and lower cost the alternate option. Accordingly, the recommendation was made of extending its use to other areas in the hospital.
2019 年 10 月，在一家三级儿科转诊医院的（HIMFG）的四个病房中实施了自动化手部卫生监测系统（AHHMS），这些病房的医院获得性感染（HAI）发生率最高。在此项研究之前，尚未评估该系统的临床和经济影响。本研究旨在评估 AHHMS 是否是降低 HIMFG 中 HAI 的一种具有成本效益的替代方案。
对医院进行了全面的成本效益经济评估。评估的替代方案为 AHHMS 的实施和 AHHMS 的不实施（历史趋势）。感兴趣的结果是每千名患者日的感染率和因预防感染而节省的成本。每千名患者日（PD）的感染率数据是从医院流行病学部门获得的，与 AHHMS 有关。至于历史趋势，为最近的 6 年设计了一个感染率模型。感染成本是从关于该主题的可用文献综述中获得的，实施的 AHHMS 的成本是由医院提供的。评估期为 6 个月。估计了增量成本效益比。成本以美元（2021 年）报告。对不同参数进行了单变量敏感性和阈值分析。
与不实施该系统相比，AHHMS 替代方案的总估计成本代表了潜在的节省，从 308927 美元到 546795 美元不等（464102 美元对 773029 美元至 1010898 美元），为期 6 个月。AHHMS 的效果反映在感染人数的减少上，与不实施相比，感染人数减少了 46-79 人（43.4%-56.7%）（60 人对 106-139 人感染）。
鉴于 AHHMS 的成本效益和较低的替代方案成本，它被认为是 HIMFG 的一种节省成本的替代方案。因此，建议将其在医院的其他区域使用。
