Bed-days and costs associated with the inpatient burden of healthcare-associated infection in the UK

Manoukian, Sarkis; Stewart, S.; Graves, Nicholas; Mason, Helen; Robertson, Chris; Kennedy, Sharon; Pan, Jiafeng; Kavanagh, Kimberley; Haahr, Lynne; Adil, Mahmood; Dancer, Stephanie J.; Cook, Brian; Reilly, Jacqui

doi:10.1016/j.jhin.2020.12.027

Cited by 37 publications

(26 citation statements)

References 34 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although UTIs showed no excess LOS overall in the ECONI study, this is not to say that the HAI had no impact on the patients or the health system e they simply did not cause patients to stay longer in hospital. The impact of UTIs on the healthcare system has been demonstrated elsewhere [59,60]. Further, UTIs are associated with secondary BSI, and therefore the importance of prevention of UTI remains critical.…”

Section: Discussionmentioning

confidence: 99%

Impact of healthcare-associated infection on length of stay

Stewart

Robertson

Pan

et al. 2021

Journal of Hospital Infection

Self Cite

View full text Add to dashboard Cite

Background: Increased length of stay (LOS) for patients is an important measure of the burden of healthcare-associated infection (HAI). Aim: To estimate the excess LOS attributable to HAI. Methods: This was a one-year prospective incidence study of HAI observed in one teaching hospital and one general hospital in NHS Scotland as part of the Evaluation of Cost of Nosocomial Infection (ECONI) study. All adult inpatients with an overnight stay were included. HAI was diagnosed using European Centres for Disease Prevention and Control definitions. A multi-state model was used to account for the time-varying nature of HAI and the competing risks of death and discharge. Findings: The excess LOS attributable to HAI was 7.8 days (95% confidence interval (CI): 5.7e9.9). Median LOS for HAI patients was 30 days and for non-HAI patients was 3 days. Using a simple comparison of duration of hospital stay for HAI cases and non-cases would overestimate the excess LOS by 3.5 times (27 days compared with 7.8 days). The greatest impact on LOS was due to pneumonia (16.3 days; 95% CI: 7.5e25.2), bloodstream infections (11.4 days; 5.8e17.0) and surgical site infection (SSI) (9.8 days; 4.5e15.0). It is estimated that 58,000 bed-days are occupied due to HAI annually. Conclusion: A reduction of 10% in HAI incidence could make 5800 bed-days available. These could be used to treat 1706 elective patients in Scotland annually and help reduce the number of patients awaiting planned treatment. This study has important implications for investment decisions in infection prevention and control interventions locally, nationally, and internationally.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of healthcare-associated infection on length of stay

Stewart

Robertson

Pan

et al. 2021

Journal of Hospital Infection

Self Cite

View full text Add to dashboard Cite

show abstract

“…We calculated HAI costs using two separate methods-direct costs; and opportunity costs associated with lost bed days. The direct costs tabulated costs that can be directly attributed to patient care including antibiotics, tests, and procedures, but excluded overhead and manpower costs (see Table 2) [17]. These direct costs represent costs that are potentially recoverable by the hospital for redirection to other purposes if the patient care service for the HAI was not rendered.…”

Section: Discussionmentioning

confidence: 99%

“…We estimated the cost of CRE HAIs to Singapore hospitals using two approaches. The direct cost approach represented resources that may be given to other patients if CRE HAI rates were reduced [17]. To estimate the resources incurred, we applied assumptions for infection control and treatment similar to the methods used by Bartsch et al [4].…”

Section: Discussionmentioning

confidence: 99%

Estimating the economic cost of carbapenem resistant Enterobacterales healthcare associated infections in Singapore acute-care hospitals

Cai

Hoo

Lee

et al. 2022

PLOS Glob Public Health

View full text Add to dashboard Cite

Quantifying the costs of hospital associated infections (HAIs) caused by carbapenem-resistant Enterobacterales (CRE) can aid hospital decision makers in infection prevention and control decisions. We estimate the costs of a CRE HAI by infection type and the annual costs of CRE HAIs to acute-care hospitals in Singapore. We used tree diagrams to estimate the costs (in Singapore dollar) of different CRE HAI types from the health service perspective and compared them to the costs of carbapenem-susceptible HAIs. We used two approaches to estimate costs–direct costs of consumables for infection prevention and treatment; and costs associated with lost bed days. Cost of a HAI were extrapolated to annual CRE HAI incidence in Singapore acute-care hospitals to estimate the annual cost to the hospitals. We found that the cost of a CRE HAI based on direct cost and lost bed days are SGD$9,913 (95% CI, SGD$9,431–10,395) and SGD$10,044 (95% CI, SGD$9,789–10,300) respectively. CRE HAIs are markedly higher than the carbapenem-susceptible HAIs for all infection types. In both approaches, CRE pneumonia was the costliest infection. Based on a CRE HAI incidence of 233 per 100,000 inpatient admissions, CRE HAIs costed SGD$12.16M (95% CI, SGD$11.84–12.48M) annually based on direct costs, and SGD$12.33M (95% CI, SGD$12.01–12.64M) annually based on lost bed days. In conclusion, we described the cost of CRE HAIs in Singapore hospitals and identified infections with the highest costs. The findings may be useful in informing future economic evaluations of competing CRE HAI prevention and treatment programmes.

show abstract

“…Hospital-acquired infections, predominantly blood-stream infections and pneumonia, are an important, expensive, and alarming problem for health systems worldwide, as well as being the main cost of bed-days lost [1]. Enterobacterales and Pseudomonas aeruginosa are the leading bacteria associated with healthcare infections; furthermore, there has been an alarming increase in multidrug-resistant microorganisms, including resistance to carbapenems [2]; by far the most important mechanism is related to ß-lactamases synthesis, such as carbapenemases [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Lateral Flow Immunochromatography and Phenotypic Assays to PCR for the Detection of Carbapenemase-Producing Gram-Negative Bacteria, a Multicenter Experience in Mexico

et al. 2023

View full text Add to dashboard Cite

The identification of carbapenemase-producing Enterobacterales and Pseudomonas aeruginosa is important for treating and controlling hospital infections. The recommended methods for their identification require a long waiting time, technical training, and expertise. Lateral flow immunoassays such as NG-Test CARBA 5® overcome these needs. We analyzed 84 clinical isolates of carbapenem-resistant Enterobacterales and P. aeruginosa from four different hospitals in a two-year period. Antimicrobial resistance patterns were confirmed with the broth dilution method. Evaluation of KPC, VIM, NDM, IMP, and OXA-48-like enzymes was performed and compared to NG-Test CARBA 5 and phenotypic assays. Enterobacterales represented 69% of isolates and P. aeruginosa represented 31%. Carbapenemase-producing strains were 51 (88%) of Enterobacterales and 23 (88.4%) of P. aeruginosa; 20 (34%) and 23 (88%) were Class B ß-lactamases, respectively. The NG-Test CARBA 5® assay for Enterobacterales showed high sensitivity (98%), specificity (100%), and PPV (100%); however, it did not for P. aeruginosa. The Kappa concordance coefficient was 0.92 for Enterobacterales and 0.52 for P. aeruginosa. NG-Test CARBA 5® is a fast and easy-to-use assay. In Enterobacterales, we found excellent agreement in our comparison with molecular tests. Despite the low agreement in P. aeruginosa, we suggest that this test could be used as a complementary tool.

show abstract

Bed-days and costs associated with the inpatient burden of healthcare-associated infection in the UK

Cited by 37 publications

References 34 publications

Impact of healthcare-associated infection on length of stay

Impact of healthcare-associated infection on length of stay

Estimating the economic cost of carbapenem resistant Enterobacterales healthcare associated infections in Singapore acute-care hospitals

Comparison of Lateral Flow Immunochromatography and Phenotypic Assays to PCR for the Detection of Carbapenemase-Producing Gram-Negative Bacteria, a Multicenter Experience in Mexico

Contact Info

Product

Resources

About