Hastane İnfeksiyonlarında Maliyet Analizi: Olgu-Kontrol Çalışması

Yıl 2008, Cilt: 5 Sayı: 1, 15 - 21, 01.04.2008

Bensu Gürsoy

Öz

Giriş: Hastane İnfeksiyonları morbidite ve yüksek mortalite, hastanede kalış süresinin uzaması ve artmış hasta bakım maliyeti ile önem oluşturmaktadır. Amaç: Bu çalışma Pamukkale Üniversitesi Hastanesi’nde infekte olmayan kontrol grubu ile infekte hastaların karşılaştırılması ile hastane infeksiyonlarının maliyetini ve hastanede kalış süresini tespit etmek için yapıldı. Materyal-Metod: Çalışmada hastane infeksiyonu olan 102 ve hastane infeksiyonu olmayan 125 hastadan toplanan veriler bilgisayar programına kaydedildi SPSS 10.0 . Sonuç: Üriner sistem infeksiyonları, pnömoni ve cerrahi alan infeksiyonları en yaygın hastane infeksiyonlarıydı. Toplam yatış süresi infekte olan ve olmayan kontrollerde sırasıyla 19.1 ve 10.0 gündü p

Anahtar Kelimeler

Hastane Infeksiyonları, Maliyet, Kalış Süresi, Mortalite Oranları

Economic Analysis Of Hospital Acquired Infections: A Case-Control Study

Öz

Introduction: Hospıtal acquired infections HAI constitute an important with morbidity, and high mortality, prolongation of hospital stay, and increased costs of direct patient care. Aim: This study was conducted in Pamukkale University Hospital in order to determine in cost of hospıtal acquired infections and length of hospitalization by matching infected patients with uninfected controls. Material-Methods: Data collected from 102 individuals with hospıtal acquired infections and 125 controls without hospıtal acquired infections were recorded by using a computer program SPSS 10.0 . Results: Urinary tract infections, pneumoniae and surgical wound infections were the most common hospıtal acquired infections. The mean total length of stay was 19.1 and 10.0 days for infected patients with uninfected controls, respectively p

Anahtar Kelimeler

Hospital Acquired Infections, Cost, Length of Stay, Mortality Rates

Kaynakça

• Jarvis WR. Selected aspects of the socioeconomic impact of nosocomial infections: Morbidity, mortality, cost and prevention. Epidemiol 1996;17:552-57 Control Hosp
• Plowmann R, Graves N, Griffin MAS, et al. The rate and cost of hospital-acquired infections occuring in patients admitted to selected specialities of a district general hospital in England and the national burden imposed. J Hosp Infect 2001;47:198-209
• Yalcin AN. Socioeconomic Burden of Nosocomial Infections. Indian J Med Sciences 2003;57: 450-456
• Yalçın AN. İnfeksiyon kontrolünde maliyet analizi; Hastane İnfeksiyonları. Editörler: Doğanay M, Ünal S. Birinci Baskı. Ankara. Bilimsel Tıp Yayınevi 2003; 125-134
• Garner JS, Jarwis WR, Emori TG, et al.: CDC infections, 1988. Am J Infect Control nosocomial
• Haley RW, Morgan WM, Culver DH, et al. Update from the SENIC project. Hospital infection control: recent progress and opportunities under prospective payment. Am J Infect Control. 1985;13: 97-108
• Keresedizle T, Mangay MA, Galacas A: Nosocomial infections-what WHO is doing? J Hosp Infect 1984; 5:7-12
• Yalcin AN, Hayran M, Unal S. Economic Analysis of Nosocomial Infections in a Turkish University Hospital. J Chemother 1997;9: 411– 14
• French GL, Cheng AFB. Measurement of the costs of the hospital infection by prevelance surveys. J Hosp Infect , 1991;18 : 65-72
• Westwood JCN, Legrace S, Mitchell MA. Hospital Acquired İnfection: Present and future impact and need for positive action. Can Med Assoc J 1974;110:769- 74
• Rosenthal VD, Guzman SN, Orellano PW. Nosocomial infections in medical- surgical intensive care units in Argentina: Attributable mortality and length of stay. Am J Infect Control 2003;31: 291-95
• Diaz Molina C, Garcia Martin M, Buena Cavallinas A, et al. The estimation of the cost nosocomial infection is an intensive care unit. Medicina Clinica 1993; 100: 329-32
• Orrett F A, Brooks P J, Richardson EG. Nosocomial ınfections in a rural regional hospital in a developing country : Infections rates by site, service, cost and infection control practice. Infect Control Hosp Epidemiol 1998;19:136-40
• Mahieu LM, Buitenweg N, Beutels P, De Dooy JJ. Additional hospital stay and charges infections in a neonatal intensive care unit. J Hosp Infect. 2001;47: 223- 29
• Leroyer A, Bedu A, Lombrail P, et al. Prolongation of hospital stay and extra costs due to hospital-acquired infection in a neonatal unit. J Hosp Infect. 1997;35: 37-45
• Astagneau P, Fleury L, Leroy S, et al. Cost of antimicrobial treatment for nosocomial infections based on a French prevalence survey. J Hosp Infect 1999;42:303–12
• Dinkel RH, Lebok V. A survey of nosocomial infections and their influence on hospital mortality rates. J Hosp Infect 1994;28: 297-304
• Haley RW, Schaberg DR, Crossley KB, et al. Extra charges and prolongation of stay attributable to nosocomial infections: a prospective interhospital comparison. Am J Med, 1981; 70:1-8
• Haley RW, Scberg DR, Van Allmenn SD, Mc Gowen JE. Estimating the extra charges hospitalization infections: A comparison of methods. J Infect Dis 1980;141:248-57 of due to nosocomial
• Green M, Rubeinstein E, Amit P. Estimating the effects of nosocomial infections on the length of hospitalisation. J Infect Dis 1982;145:666-72
• Andersen BM. Economic consequences of hospital infections in a 1,000-bed university hospital in Norway. Infect Control Hosp Epidemiol. 1998;19: 805-07 22. Public health focus: Surveillance, prevention, and control of nosocomial infections. MMWR Morb Mortal Wkly Rep 1992, 41:783-87.
• Boyce JM, Potter-Bynoe G, Dziobek L, Solomon SL: Nosocomial pneumonia in Medicare patients. Hospital costs and reimbursement prospective payment system. Arch Intern Med 1991;151:1109-14 under the
• Dietrich ES, Demmler M, Schulgen G, et al. Nosocomial pneumonia: a cost-of- illness analysis. Infection 2002, 30:61-67
• Erbay RH, Yalcin AN, Zencir M, Serin S, Atalay H. Cost and risk factors for ventilation-associated pneumoniae in a Turkish university hospital’s ıntensive care unit: a case-control study. BMC Pulm Med. 2004;4:1-7
• Inan D, Saba R, Gunseren F, Ongut G, Turhan O, Yalcin AN, Mamikoglu L. Daily antibiotic cost of nosocomial infections in a Turkish University Hospital. BMC Infect Dis. 2005;5: 1-6
• Haley RW. Measuring the costs of nosocomial estimating the economic burden on the hospital. Am J Med 1991;91:32-8
• Jones RN. Impact of changing pathogens and antimicrobial susceptibility patterns in the treatment of serious infections in hospitalized 1996;100:3-12 Am J Med
• Evans HL, Lefrak SN, Lyman J et al. Cost of Gram-negatif resistance. Crit Care Med
• Liss RH, Batchelor FR. Economic evaluations of antibiotic use and resistance-a perspective report of task force 6. Rev Infect Dis 1987:9; 297-312