Epidemiology and economic impact of health care-associated infections and cost-effectiveness of infection control measures at a Thai university hospital

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• 作者：Pinyo Rattanaumpawan ; MD ; MSCE ; PhD ; ^{pinyo.rat@mahidol.ac.th} ; Visanu Thamlikitkul ; MD
• 关键词：Epidemiology ; Health care&ndash ; associated infection ; Infection control
• 刊名：American Journal of Infection Control
• 出版年：2017
• 出版时间：1 February 2017
• 年：2017
• 卷：45
• 期：2
• 页码：145-150
• 全文大小：620 K
• 卷排序：45

文摘

Data on clinical and economic impact of health care–associated infections (HAIs) from resource limited countries are limited. We aimed to determine epidemiology and economic impact of HAIs and cost-effectiveness of infection prevention and control measures in a resource-limited setting.MethodsA retrospective cohort study was conducted among hospitalized patients at Siriraj Hospital, Thailand. Results from the cohort were subsequently used to conduct cost-effective analysis (CEA) to compare the comprehensive implementation of individualized bundling infection control measures (IBICMs) with regular infection control care.ResultsFrom February-May 2013, there were 515 hospitalizations (497 patients) with 7,848 hospitalization days. Cumulative incidence of HAIs was 23.30%, and the incidence rate of HAIs was 18.66 ± 44.19 per 1,000 hospitalization days. Hospital mortality among those with and without HAIs was 33.33% and 20.00%, respectively (P < .001). The adjusted cost attributable to HAIs was $704.72 ± $226.73 (P < .001). CEA identified IBICMs as a non-dominated strategy, with an incremental cost-effectiveness ratio of −$20,444.62 per life saved.ConclusionsHAI is significantly related with higher hospital mortality, longer length of stay, and higher hospitalization costs. IBICMs were confirmed to be cost-effective at Siriraj Hospital. Implementing this intervention could improve care quality and save costs.