Extra charges and prolongation of stay attributable to nosocomial infections: A prospective interhospital comparison

Haley, Robert W.; Schaberg, Dennis R.; Crossley, Kent; Allmen, S. D. Von; McGowan, John E.

doi:10.1016/0002-9343(81)90411-3

Cited by 319 publications

(150 citation statements)

References 16 publications

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“…Plowman et al, 18 2001 Haley et al, 1 1981 Haley et al, 1 1981 Scheckler, 3 1980 Haley et al, 1 1981 Medina et al, 26 1997 Rubinstein et al, 2 1982 Coello et al, 17 All studies used matched control subjects for attribution of additional length of stay to hospital-acquired infection, except where * indicates that a cohort study with regression modeling was used and + indicates that the concurrent method or physician review was used. All studies used matched control subjects for attribution of additional length of stay to hospital-acquired infection, except where * indicates that a cohort study with regression modeling was used, f indicates that the concurrent method or physician review was used, and * indicates that the estimate was not used in modeling presented in this article.…”

Section: A P P E N D I Xmentioning

confidence: 99%

Modeling the Costs of Hospital-Acquired Infections in New Zealand

Graves

Nicholls²,

Morris³

2003

Infect. Control Hosp. Epidemiol.

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OBJECTIVE:To model the economic costs of hospitalacquired infections (HAIs) in New Zealand, by type of HAL DESIGN: Monte Carlo simulation model. SETTING: Auckland District Health Board Hospitals (DHBH), the largest publicly funded hospital group in New Zealand supplying secondary and tertiary services. Costs are also estimated for predicted HAIs in admissions to all hospitals in New Zealand.PATIENTS: All adults admitted to general medical and general surgical services.METHOD: Data on the number of cases of HAI were combined with data on the estimated prolongation of hospital stay due to HAI to produce an estimate of the number of bed days attributable to HAI. A cost per bed day value was applied to provide an estimate of the economic cost. Costs were estimated for predicted infections of the urinary tract, surgical wounds, the lower and upper respiratory tracts, the bloodstream, and other sites, and for cases of multiple sites of infection. Sensitivity analyses were undertaken for input variables. RESULTS:The estimated costs of predicted HAIs in medical and surgical admissions to Auckland DHBH were $10.12 (US $4.56) million and $8.64 (US $3.90) million, respectively. They were $51.35 (US $23.16) million and $85.26 (US $38.47) million, respectively, for medical and surgical admissions to all hospitals in New Zealand.CONCLUSIONS: The method used produces results that are less precise than those of a specifically designed study using primary data collection, but has been applied at a lower cost. The estimated cost of HAIs is substantial, but only a proportion of infections can be avoided. Further work is required to identify the most cost-effective strategies for the prevention of HAI (Infect Control Hosp Epidemiol 2003;24:214-223 27 Israel, 28 and France. 29 The findings illustrate the impact of the disease on the acute and the community healthcare sectors, patients, caregivers, and the wider economy. These data have been used to raise the profile of hospital-acquired infection among policy makers 30 and, if appropriately derived, they proxy the value of the potential economic benefits that result from programs that prevent hospitalacquired infection. 31 Although the prevalence of hospital-acquired infections in New Zealand hospitals and estimates of the cumulative incidence have been reported, 3233 no estimates of the economic cost of these infections have been published. The purpose of this article is to model the cost attributable to hospital-acquired infections occurring among adult patients admitted to the general medical and surgical services of Auckland District Health Board Hospitals for calendar year 1999 and patients admitted to all hospitals in New Zealand for the 1998-1999 financial year.The cost analysis includes only hospital costs because recent work has shown that 93.4% of the total costs of hospital-acquired infection fall on the hospital sector 34 and assessing the remaining costs, those that fall on primary and community care services and the patients themselves, would involve extensi...

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Section: A P P E N D I Xmentioning

confidence: 99%

Modeling the Costs of Hospital-Acquired Infections in New Zealand

Graves

Nicholls²,

Morris³

2003

Infect. Control Hosp. Epidemiol.

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“…Nosocomial infections (NIs) are a major complication adults and children (1,2). The national nosocomial infections surveillance system (NNIS) is a surveillance system to obtain national data on nosocomial infections.…”

Section: Introductionmentioning

confidence: 99%

“…In the United States between 5-10% of hospitalized patients in acute care units suffer NI (1,(5)(6)(7)(8)(9). The frequency of NI in children seems to be lower and is negatively correlated with age, which is ranging from 7-9 % for infants younger than 1 year old to 1.5-4 % for hospitalized l0 year-old children (10,11).…”

Section: Introductionmentioning

confidence: 99%

Microbiological Evaluation of Nosocomial Infections by Using National Nosocomial Infection Surveillance (NNIS) System

Oskouie

Rezaie

Panahi

et al. 2013

Arch Pediatr Infect Dis

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Background: Healthcare-associated infections such as nosocomial infections (NI) are important causes of mortality worldwide. Objectives: In this study we evaluated the nosocomial infections terms of microbiology (resistance, culturing, etc.) in a referral pediatric hospital based on national nosocomial infection surveillance system. Patients and Methods:In an epidemiological surveillance study during a 14 month-period, patients who had no infection or not been in incubation period at the admission time, but had positive culture after the third day of admission, were defined as a case of nosocomial infection. Characteristics and features of each infection were coded and classified. Results: The total number of hospitalized patients was 7730 and the total number of hospitalized days was 30147 days. The mean age of 103 patients with nosocomial infection was 21.59 ± 3.87 months and the average duration of hospital stay was 25.53 ± 17.63 days. The incidence of NI was 1.33 per 100 hospital discharges and 0.34 per 100 hospital days. The incidence of NI was 1.33 infections per 100 hospital discharges and 0.34 infection per 100 hospital days. The most frequently isolated organisms included coagulase-negative Staphylococcus, Klebsiella, Serratia, yeast, E. coli and Pseudomonas respectively. The frequency of antimicrobial resistant isolated organisms was high. Half of isolated S. aureus were Methicillin resistant. Klebsiella was resistant to third generation Cephalosporins in 87%, against aminoglicosides in 80%, and against Imipenem in 52%. 100% of isolated pseudomonas were resistant to third generation Cephalosporins and Imipenem. 27 cases (of 103 cases) (26.2%) expired with the diagnosis of NI. Conclusions: Increasing frequency of anti-microbial resistant isolates emphasizes the necessity for bacteriological monitoring of hospitalized children.

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“…4 CRBIs prolong hospital stays from 7 to 21 days and account for an estimated increase in hospital costs of $ 3000-40 000 per patient. [5][6][7] In addition, an estimated 10-20% attributable mortality owing to nosocomial CRBI has been reported. 6 Only 20% of CVCs removed because of suspected infection actually prove to be infected, and the diagnosis is always retrospective.…”

Section: Introductionmentioning

confidence: 99%

Detection of catheter-related bloodstream infections by the Gram stain–acridine orange leukocyte cytospin test in hematopoietic stem cell transplant recipients

Abdelkefi¹,

Achour²,

Torjman³

et al. 2006

Bone Marrow Transplant

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In patients with central venous catheters (CVCs), catheter-related bloodstream infections (CRBI) are a prominent cause of morbidity, excess hospital costs, and in some cases mortality. The aim of this prospective study was to assess the validity of the Gram stain-acridine orange leukocyte cytospin (AOLC) test for the diagnosis of CRBI in hematopoietic stem cell transplant (HSCT) recipients with nontunnelled CVCs, using the differentialtime-to-positivity (DTP)/clinical criteria as the criterion standard to define CRBIs. CVCs were externalized, nontunnelled, polyurethane double lumen catheters (Arrows, Readings, USA). All CVCs were placed in the subclavian vein by the infraclavicular approach, in the operating room. Catheters were inserted percutaneously, using the Seldinger technique. Study catheters were not exchanged over guidewires. Between May 2002 and December 2004, a total of 245 consecutive patients were included. Twenty-six of the 245 patients (10.6%) had CRBI as determined by the DTP method. The Gram stain-AOLC was positive in only two patients (7.6%) with a CRBI. Our results suggest that the Gram stain-AOLC test is not useful for the diagnosis of catheterrelated bloodstream infection in HSCT recipients.

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Extra charges and prolongation of stay attributable to nosocomial infections: A prospective interhospital comparison

Cited by 319 publications

References 16 publications

Modeling the Costs of Hospital-Acquired Infections in New Zealand

Modeling the Costs of Hospital-Acquired Infections in New Zealand

Microbiological Evaluation of Nosocomial Infections by Using National Nosocomial Infection Surveillance (NNIS) System

Detection of catheter-related bloodstream infections by the Gram stain–acridine orange leukocyte cytospin test in hematopoietic stem cell transplant recipients

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