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2021年新西兰公立医院医疗保健相关感染的负担

The burden of healthcare-associated infections in New Zealand public hospitals 2021.

作者信息

Morris Arthur J, Hensen Mike, Graves Nicholas, Cai Yiying, Wolkewitz Martin, Roberts Sally A, Grae Nikki

机构信息

Infection Prevention & Control Programme, Health Quality & Safety Commission, Auckland, New Zealand.

New Zealand Institute of Economic Research, Wellington, New Zealand.

出版信息

Infect Control Hosp Epidemiol. 2024 Oct 4;45(10):1-7. doi: 10.1017/ice.2024.95.

Abstract

BACKGROUND

There are no contemporary data on the burden of healthcare-associated infections (HAIs) in New Zealand.

OBJECTIVES

To estimate the economic burden of HAIs in adults in New Zealand public hospitals by number and monetary value of bed days lost; number of deaths, number of life years lost, and the monetary value (in NZ dollars); Accident Compensation Commission (ACC) HAI treatment injury payments; and disability-adjusted life years (DALYs).

METHODS

The annual incidence rate was calculated from the observed prevalence of HAIs in New Zealand, and length of patient stays. Total HAIs for 2021 were estimated by multiplying adult admissions by incidence rates. The excess length of stay and mortality risk attributed to those with HAI was calculated using a multistate model. Payments for treatment injuries were obtained from the ACC. DALYs for HAIs were estimated from the literature.

RESULTS

The incidence rate of HAI was 4.74%, predicting 24,191 HAIs for 2021, resulting in 76,861 lost bed days, 699 deaths, with 9,371 years of life lost (YoLL). The annual economic burden was estimated to be $955m comprised of $121m for lost bed days, $792m for cost of YoLL, and $43m ACC claims. There were 24,165 DALY which is greater than many other measured injuries in New Zealand, eg motor vehicle traffic crashes with 20,328 DALY.

CONCLUSIONS

HAIs are a significant burden for patients, their families, and the public health system. Preventive guidelines for many HAIs exist and a strategic plan is needed to reduce HAIs in New Zealand.

摘要

背景

目前尚无关于新西兰医疗保健相关感染(HAIs)负担的当代数据。

目的

通过损失的床日数量和货币价值、死亡人数、生命年损失数及其货币价值(以新西兰元计);意外赔偿委员会(ACC)对HAIs治疗损伤的赔付;以及伤残调整生命年(DALYs),估算新西兰公立医院成人HAIs的经济负担。

方法

根据新西兰观察到的HAIs患病率和患者住院时长计算年发病率。2021年的HAIs总数通过将成人入院人数乘以发病率来估算。使用多状态模型计算HAIs患者的额外住院时长和死亡风险。从ACC获取治疗损伤的赔付金额。根据文献估算HAIs的DALYs。

结果

HAIs的发病率为4.74%,预计2021年有24,191例HAIs,导致76,861个床日损失、699例死亡,损失9,371个生命年(YoLL)。年度经济负担估计为9.55亿新西兰元,其中包括1.21亿新西兰元的床日损失、7.92亿新西兰元的生命年损失成本以及4300万新西兰元的ACC索赔。有24,165个伤残调整生命年,这比新西兰许多其他已测量的损伤(如机动车交通事故,有20,328个伤残调整生命年)要多。

结论

HAIs对患者及其家庭以及公共卫生系统而言是一项重大负担。许多HAIs都有预防性指南,新西兰需要一项战略计划来减少HAIs。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8dd5/11611504/52ad66691360/S0899823X24000953_fig1.jpg

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