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非洲医疗保健相关感染的财务和经济成本。

Financial and economic costs of healthcare-associated infections in Africa.

机构信息

Innate Values Ltd., Bath, UK.

Water Global Practice, World Bank, Washington, DC, USA.

出版信息

J Hosp Infect. 2024 Aug;150:1-8. doi: 10.1016/j.jhin.2024.04.015. Epub 2024 May 7.

Abstract

BACKGROUND

Healthcare-associated infections (HAIs) remain a global health challenge, and have elevated rates in Sub-Saharan Africa. HAIs impact patients and their families by causing illness, prolonged hospital stay, potential disability, excess costs and, sometimes, death. The costs of HAIs are increasing due to spreading antimicrobial resistance. A major risk factor for HAIs is lack of water, sanitation and hygiene (WASH); environmental cleaning and healthcare waste management. In Sub-Saharan Africa, these services are lacking in at least 50% of healthcare facilities.

AIM

To estimate the costs associated with HAIs at national level in 14 countries in Sub-Saharan Africa.

METHODS

Economic methodologies were employed to estimate the medical costs, productivity losses and value of premature death from HAIs, drawing on national statistics and published studies to populate the economic model.

RESULTS

In 2022, the number of HAIs was estimated at 4.8 million, resulting in 500,000 deaths. Health-related economic losses amounted to US$13 billion per year, equivalent to 1.14% of combined gross domestic product and US$15.7 per capita. Healthcare costs were US$500 per HAI, and represented 5.6% of total health expenditure. The costs of providing basic WASH were US$0.91 per capita, which, if they reduced HAIs by 50%, would result in benefit-cost ratios of 1.6 (financial healthcare savings alone) and 8.6 (all economic benefits).

CONCLUSION

HAIs have a major health and economic burden on African societies, and a significant proportion can be prevented. It is critical that health policy makers and practitioners dedicate policy space, resources and training to address HAIs.

摘要

背景

医疗保健相关感染(HAI)仍然是一个全球性的健康挑战,在撒哈拉以南非洲地区的发生率更高。HAI 通过导致疾病、延长住院时间、潜在残疾、额外费用,有时甚至死亡,对患者及其家属产生影响。由于抗菌药物耐药性的传播,HAI 的成本不断增加。HAI 的一个主要危险因素是缺乏水、环境卫生和个人卫生(WASH);环境清洁和医疗废物管理。在撒哈拉以南非洲,至少有 50%的医疗保健设施缺乏这些服务。

目的

估计撒哈拉以南非洲 14 个国家的 HAI 相关成本。

方法

采用经济方法估计医疗费用、因 HAI 导致的生产力损失和过早死亡的价值,利用国家统计数据和已发表的研究来填充经济模型。

结果

2022 年,HAI 数量估计为 480 万例,导致 50 万人死亡。与健康相关的经济损失每年达 130 亿美元,相当于国内生产总值总和的 1.14%,人均 15.7 美元。医疗保健费用为每例 HAI 500 美元,占总卫生支出的 5.6%。提供基本 WASH 的费用为每人 0.91 美元,如果将 HAI 减少 50%,则将产生 1.6(仅财务医疗储蓄)和 8.6(所有经济利益)的效益成本比。

结论

HAI 对非洲社会的健康和经济造成了重大负担,其中很大一部分是可以预防的。卫生政策制定者和从业者必须投入政策空间、资源和培训,以解决 HAI 问题。

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