Estimating the Direct Medical Economic Burden of Health Care–Associated Infections in Public Tertiary Hospitals in Hubei Province, China

Li, Hao; Liu, Xinliang; Cui, Dan; Wang, Quan; Mao, Zongfu; Fang, Liang; Zhang, Furong; Yang, Ping; Wu, Huiling; Ren, Nili; He, Jianyun; Sun, Jing

doi:10.1177/1010539517717366

Cited by 21 publications

(16 citation statements)

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“…Currently, there are few economic studies about HAI in Mainland China. Studies from Hubei and Sichuan demonstrated that the attributable cost of HAI were US$6173.02 and $2439.77 per case, respectively [13,14]. Another Chinese study of catheter-related bloodstream infections indicated the total cost attributable was US $3528.6 per case [15].…”

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confidence: 99%

Estimating length of stay and inpatient charges attributable to hospital-acquired bloodstream infections

Zhang

Johnston

et al. 2020

Antimicrob Resist Infect Control

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Background: Hospital-acquired bloodstream infection (BSI) is associated with high morbidity and mortality and increases patients' length of stay (LOS) and hospital charges. Our goals were to calculate LOS and charges attributable to BSI and compare results among different models. Methods: A retrospective observational cohort study was conducted in 2017 in a large general hospital, in Beijing. Using patient-level data, we compared the attributable LOS and charges of BSI with three models: 1) conventional non-matching, 2) propensity score matching controlling for the impact of potential confounding variables, and 3) risk set matching controlling for time-varying covariates and matching based on propensity score and infection time. Results: The study included 118,600 patient admissions, 557 (0.47%) with BSI. Six hundred fourteen microorganisms were cultured from patients with BSI. Escherichia coli was the most common bacteria (106, 17.26%). Among multidrug resistant bacteria, carbapenem-resistant Acinetobacter baumannii (CRAB) was the most common (42, 38.53%). In the conventional non-matching model, the excess LOS and charges associated with BSI were 25.06 days (P < 0.05) and US$22041.73 (P < 0.05), respectively. After matching, the mean LOS and charges attributable to BSI both decreased. When infection time was incorporated into the risk set matching model, the excess LOS and charges were 16.86 days (P < 0.05) and US$15909.21 (P < 0.05), respectively. Conclusion: This is the first study to consider time-dependent bias in estimating excess LOS and charges attributable to BSI in a Chinese hospital setting. We found matching on infection time can reduce bias.

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confidence: 99%

Estimating length of stay and inpatient charges attributable to hospital-acquired bloodstream infections

Zhang

Johnston

et al. 2020

Antimicrob Resist Infect Control

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“…On the other hand, a statistical report of traffic accidents or an epidemiological investigation of factors related to the traffic accidents at the local level will not be considered as global. Studies conducted in a local hospital on drug resistance to antibiotics and associated cost are global if expected findings can inform other countries to prevent abuse of antibiotics [77]. Lastly, studies supported by international health programs can be packaged as global simply by broadening the vision from international to global.…”

Section: Reframing a Local Research Study As Globalmentioning

confidence: 99%

What is global health? Key concepts and clarification of misperceptions

Chen

Lucero‐Prisno

et al. 2020

glob health res policy

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The call for "Working Together to Build a Community of Shared Future for Mankind" requires us to improve people's health across the globe, while global health development entails a satisfactory answer to a fundamental question: "What is global health?" To promote research, teaching, policymaking, and practice in global health, we summarize the main points on the definition of global health from the Editorial Board Meeting of Global Health Research and Policy, convened in July 2019 in Wuhan, China. The meeting functioned as a platform for free brainstorming, indepth discussion, and post-meeting synthesizing. Through the meeting, we have reached a consensus that global health can be considered as a general guiding principle, an organizing framework for thinking and action, a new branch of sciences and specialized discipline in the large family of public health and medicine. The word "global" in global health can be subjective or objective, depending on the context and setting. In addition to dual-, multicountry and global, a project or a study conducted at a local area can be global if it (1) is framed with a global perspective, (2) intends to address an issue with global impact, and/or (3) seeks global solutions to an issue, such as frameworks, strategies, policies, laws, and regulations. In this regard, global health is eventually an extension of "international health" by borrowing related knowledge, theories, technologies and methodologies from public health and medicine. Although global health is a concept that will continue to evolve, our conceptualization through group effort provides, to date, a comprehensive understanding. This report helps to inform individuals in the global health community to advance global health science and practice, and recommend to take advantage of the Belt and Road Initiative proposed by China.

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“…Both of them are associated with increasing mortality, morbidity and length of hospitalization (5). Eventually, there is an increasing economic burden on society, patients and their family (6)(7)(8). In the United States, the annual approximate number of deaths caused by HAIs was 90,000 from 1990 to 2002, corresponding to US$ 28 to US$ 45 billion per year (9).…”

Section: Introductionmentioning

confidence: 99%

“…It is the rst time to apply our research team's previous estimation framework to estimate the economic burden due to HAIs and AMR in a teaching hospital of Nepal. The framework was designed to calculate the direct economic burden attributable to HAIs and AMR in Hubei Province, China given the support from the UK (6). The idea was put forward because of the 'One Belt, One Road' initiative proposed by Chinese President Xi in 2013, aiming to improve cooperative relationship with countries included in this initiative (12).…”

Section: Introductionmentioning

confidence: 99%

The Direct Economic Disease Burden of Healthcare-associated Infections (HAIS) and Antimicrobial Resistance (AMR): A Preliminary Study in a Teaching Hospital of Nepal

Liu

Shrestha

Koju

et al. 2020

Preprint

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Background: Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) have been becoming the public and global health issues. The purpose of this study is to estimate the direct economic burden attributable to HAIs and AMR.Methods: This study applied propensity score matching (PSM) methodology to conduct a prospective case-control study of direct disease burden attributable to HAIs and AMR 16th December, 2017 to 16th April, 2018 in a teaching hospital in Nepal. Clinical information was retrieved from Hospital Health Information and electronic medical record systems, as well as the microbiology lab system. The finance system was used to determine the health expenditure and length of hospitalization of HAIs, HAIs-AMR and Non-HAIs patients. STATA 12.0 was used to conduct descriptive analysis, (bivariate) χ2 test, paired/independent T test, PSM (B=0.25a, nearest neighbour 1:1 matching, General Boosted Model, GBM). The statistically significant level was set at P < 0.05.Results: HAIs patients and HAIs-AMR patients had statistically significant higher expenditures and longer length of hospital days than Non-HAI inpatients during the study period (P<0.05). The additional average total medical expenditure, medicines expenditure, out-of-pocket expenditure and length of hospitalization per patient caused by HAIs were 17,224.93 Rupees, 11,947.49 Rupees, 15,776.57 Rupees and 7 days, respectively. In the meantime, the extra total medical expenditure, medicines expenditure, out-of-pocket expenditure and length of hospitalization attributable to HAIs-AMR were 39,879.63 Rupees, 21,173.63 Rupees, 38,770.87 Rupees and 9 days, respectively. Moreover, the percentage of out-of-pocket expenditure accounting for total medical expenditure of HAIs Group was 94.24% while it was 96.75% of HAIs-AMR Group.Conclusions: It was the first time to apply the research framework of the previous study in China to estimate the direct economic burden caused by HAIs and AMR in a teaching hospital of Nepal. HAIs and AMR have substantially led to excess direct economic burden for patients and their family due to the low Gross Domestic Product (GDP) and low health expenditure in Nepal. This calls for active collaboration with developed countries to reduce the threat caused by HAIs and AMR to prevent the transnational communication.

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Estimating the Direct Medical Economic Burden of Health Care–Associated Infections in Public Tertiary Hospitals in Hubei Province, China

Cited by 21 publications

References 20 publications

Estimating length of stay and inpatient charges attributable to hospital-acquired bloodstream infections

Estimating length of stay and inpatient charges attributable to hospital-acquired bloodstream infections

What is global health? Key concepts and clarification of misperceptions

The Direct Economic Disease Burden of Healthcare-associated Infections (HAIS) and Antimicrobial Resistance (AMR): A Preliminary Study in a Teaching Hospital of Nepal

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