The Socio-economic Burden Of Hospital Acquired Infection (1999) | National Resource for Infection Control (NRIC)

The Socio-economic Burden Of Hospital Acquired Infection (1999)

Policy, Review
Abstract: 
The study was commissioned by the Department of Health to provide a comprehensive assessment of the socio- economic burden of HAI to the hospital, community services, patients and carers. The results include incidence of HAI during the study period, health sector costs incurred during the inpatient stay, post discharge and costs to informal carers. It looks at the difficulties of extrapolating the results to the rest of the NHS especially the difficulties of measuring infections in the community following discharge from hospital plus the benefits of prevention. It makes recommendations to commissioners, providers of health care, and educational institutions involved in the education of health care personnel.
Authors: 
Plowman RGraves NGriffin MRoberts JASwan AVCookson BTaylor L.
Category: 
Economic analysis
Epidemiology
Investigation
Management
Prevention

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Summary:
The study was commissioned by the Department of Health to provide a comprehensive assessment of the socio- economic burden of HAI to the hospital, community services, patients and carers. The results include incidence of HAI during the study period, health sector costs incurred during the inpatient stay, post discharge and costs to informal carers. It looks at the difficulties of extrapolating the results to the rest of the NHS especially the difficulties of measuring infections in the community following discharge from hospital plus the benefits of prevention. It makes recommendations to commissioners, providers of health care, and educational institutions involved in the education of health care personnel.
Questions Addressed:
It provides an estimate of the annual burden of HAI’s occurring in adult, non day-case patients admitted to the specialties covered at the study hospital (medical, surgical, orthopaedic, urology, gynaecology, ear, nose and throat, elderly care and obstetric patients who underwent caesarean sections) It determines not only costs to primary and secondary care sectors but the impact of HAI on the health status of patients and the costs to patients, informal carers and the economy.
Type of Study:
Descriptive and analytical survey
Methods Valid:
Yes
Methods Valid Detail:

The inpatient analysis considered how resource use and associated costs varied between patients with and without an HAI and how these outcome measures varied with site of infection. The post discharge analysis considered how cost varied between four patient groups. Valid and appropriate for study population surveyed – some problems with extrapolation to remaining NHS Hospitals

Results Reliability:
Factors other than the presence of an HAI may have accounted for some of the additional resource use and costs incurred by infected patients, resource and cost outcomes measures were analysed using regression modelling which controlled for a range of potential confounders (age, sex, diagnosis, number of co-morbidities, admission specialty, admission type and where appropriate time of return of questionnaire) Estimates allowing for the effects of these confounders were subsequently derived from this modelling process
Problems or Biases:

As above

Relevant Studies:

1. Meers PD, Ayliffe GA, Emmerson AM, Leigh DA, Mayon-White RT, Mackintosh CA, Stongs JL, (1981) Report on the National survey of infection in hospitals 1980. Journal of Hospital Infection 2 (Supplementary): 1-112. Haley RW, White JW, Culver DH, Meade Morgan W, Emori TG, Munn VP, Hooten TM (1985) The efficacy of infection surveillance and control programmes in preventing nosocomial infections in US hospitals (SENIC) American Journal of Epidemiology 121: 182-205)3. Glenister HM, Taylor LJ, Cooke EM, Bartlett CLR (1992). A study of surveillance methods for detecting hospital infection. Public Health Laboratory Service 4. Coella R, Glenister H, Fereres J, Bartlett C, Leigh D, Sedgwick J, Cooke EM, (1993) The cost of infection in surgical patients – a case control study. Journal Hospital infection 25: 239-2505. Wilcox MH, Cunniffee JG, Trundel, Redpath (1996). Financial burden of hospital acquired Clostridium Difficile infection. Journal of Hospital Infection 34: 23-306. Glynn A, Ward V, Wilson J, Charlett A, Cookson B, Taylor L, Cole N (1997). Hospital acquired infection surveillance policies and practice – a study of the control of hospital acquired infection in 19 hospitals in England and Wales. London: PHLS7. Emmerson AM, Enstone JE, Griffin M, Kelsey MC, Smyth ETM (1996) The second national prevalence survey of infection in hospitals – overview of results. Journal of Hospital Infection 32: 175-1908. NAO, Report by the Comptroller and Auditor General – HC 230 Session 1999-2000: The Management and Control of Hospital Acquired Infection in Acute NHS Trusts in England 20009. taylor K, Plowman R, Roberts JA, (2001) The challenge of Hospital Acquired Infection. The National Audit Office. London: Stationary Office10. NAO Report by the Comptroller and Auditor General – HC 876 Session 2003-2004:: Improving patient care by reducing the risk of hospital acquired infection: A progress report. 11. Northern Ireland Healthcare-associated Infection Surveillance Centre (HISC), Scottish Surveillance of Healthcare Associated Infection Programme (SSHAIP), National Public Health Service for Wales (March 2004). Pan Celtic Collaborative Surveillance Report.

Keywords:
Hospital Acquired Infection incidence cost
Reviewer Name:
Sue Wiseman
Reviewer Post:
Nurse Consultant –Infection Control, DH
Reviewer Affiliations:
Member Advisory Committee on Dangerous Pathogens Health Protection Adviser Royal College of Nursing P/T Member Infection Control Nurses Association