Impact of Nosocomial Infections on Medical Costs, Hospital Stay, and Outcome in Hospital Patients

院內感染對住院病人之醫療花費、住院日數以及預後所造成的影響

盛望徽(Wang-Huei Sheng) ； 季瑋珠(Wei-Chu Chie) ； 陳宜君(Yee-Chun Chen) ； 洪健清(Chien-Ching Hung) ； 王振泰(Jann-Tay Wang) ； 張上淳(Shan-Chwen Chang)

《Journal of the Formosan Medical Association》 104卷5期 (2005/05) Pp. 318-326

https://doi.org/10.29828/JFMA.200505.0003

並列摘要

Background and Purpose: Nosocomial infections have been shown to be associated with increased attributable mortality, length of hospital stay, and health care costs in studies mainly conducted in western populations. However, the health care system in Taiwan differs from the typical situation in western countries, with longer hospitalization times and lower daily costs. The purpose of this study was to understand the economic and clinical impacts of nosocomial infections in Taiwan.
Methods: Between June 1, 2001 and December 31, 2001, every hospitalized patient (age≥16 years) with nosocomial infections (case group) and matched control patients without nosocomial infections of the same age, gender, underlying medical illness, clinical diagnosis at admission and disease severity (control group) were recruited. Demographic characteristics, length of hospitalization, costs and final outcomes of both groups were collected for analysis.
Results: A total of 482 patient-pairs with median age of 68 years were studied. The median length of hospital stay was 40 days for the case group and 22 days for the control group (p＜0.0001). The median hospital cost for the case group was 368,425 New Taiwan Dollars (NTD) and 165,965 NTD for the control group (p＜0.0001). The median additional hospital stay for patients with nosocomial infection was 15 days, which amounted to 127,354 NIT). The extra hospital costs were not only associated with accommodation but also fees for materials, and costs relating to pharmacy, laboratory tests and diet. Patients with nosocomial infections were more likely to have shock, organ failure and death (all p＜0.0001). Additional hospital stay and costs were not related to various infection sites and bacterial pathogens causing nosocomial infections; however, medical costs attributable to nosocomial fungal infection were higher than that of bacterial infections.
Conclusions: Nosocomial infections have a significant impact on the length of hospital stay and medical care cost. Extra costs of nosocomial infections resulted not only from prolongation of hospital stay, but also other medical costs. Infection control for preventing nosocomial infections may play an important role in reducing medical costs, hospital stay, and mortality in hospitalized patients.

並列關鍵字

Cost of illness ； Cross infection ； Health care costs ； Length of stay ； Mortality