Additional direct medical costs of nosocomial infections: an estimation from a cohort of patients in a French university hospital

• Published in: The Journal of hospital infection 2008-02, Vol.68 (2), p.130-136
• Main Authors: Defez, C, Fabbro-Peray, P, Cazaban, M, Boudemaghe, T, Sotto, A, Daurès, J.P
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Infective Agents - economics; Anti-Infective Agents - therapeutic use; Biological and medical sciences; Case-Control Studies; Cohort Studies; Cross Infection - drug therapy; Cross Infection - economics; Cross Infection - mortality; Diagnosis-Related Groups - economics; Female; France - epidemiology; General aspects; Health Care Costs; Hospital-acquired infection; Hospitals, University - economics; Human infectious diseases. Experimental studies and models; Humans; Infectious Disease; Infectious diseases; Male; Medical cost; Medical sciences; Middle Aged; Risk Factors
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2007.11.005

Summary We estimated the direct additional medical costs of nosocomial infections (NI) using a cohort study in acute and longer-term care at Nîmes University Hospital in France. Patients hospitalised between May 2001 and January 2003 with NI were considered as exposed; all others were eligible as non-exposed. Thirty patients were randomly chosen for each site of infection: respiratory tract, bloodstream, surgical site, urinary tract and other sites for a total of 150 exposed patients. Each exposed patient was matched with a non-exposed patient according to gender, age, severity of the underlying disease, diagnosis according to hospital discharge records, ward type and length of hospitalisation before inclusion. Additional direct medical costs for the exposed patients compared to the non-exposed and the difference between actual costs and the diagnosis-related group rate were measured. Costs resulting from laboratory tests, radiology, surgery and exploratory examinations, and antimicrobial agents were estimated to be €2421 for a respiratory tract infection, €1814 for a surgical site infection, €953 for a bloodstream infection and €574 for a urinary tract infection. Total additional costs of NI (direct medical costs and costs of extra length of stay) in acute care were estimated to be up to €3.2 million per year (95% confidence interval: 2,275,063–4,132,157). In conclusion, both prevention of avoidable NI and better estimation of the actual costs of NI should be priorities for all healthcare facilities.