Prof. Dr. Ata Nevzat Yalçın, MD Prof. Dr. Ata Nevzat Yalçın, MD Akdeniz University, Medicine Faculty Akdeniz University, Medicine Faculty Dept. Infectious Dis. and Clinical Microbiology Dept. Infectious Dis. and Clinical Microbiology Antalya-TURKEY Antalya-TURKEY www.webbertraining.com June 6, 2012 Sponsored by WHO Patient Safety Challenge Clean Care is Safer Care Economic impact of healthcare- associated infections in low and middle-income countries
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Prof. Dr. Ata Nevzat Yalçın, MDProf. Dr. Ata Nevzat Yalçın, MDAkdeniz University, Medicine FacultyAkdeniz University, Medicine Faculty
Dept. Infectious Dis. and Clinical MicrobiologyDept. Infectious Dis. and Clinical MicrobiologyAntalya-TURKEYAntalya-TURKEY
www.webbertraining.com June 6, 2012
Sponsored by WHO Patient Safety Challenge
Clean Care is Safer Care
Economic impact of healthcare-associated infections in low and
middle-income countries
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• Healthcare-associated infections (HAI) Healthcare-associated infections (HAI) represent an important public health problem represent an important public health problem in developing countries as in developed ones in developing countries as in developed ones today as a major cause of high morbidity, today as a major cause of high morbidity, mortality and economic consequences in mortality and economic consequences in hospitalized patients.hospitalized patients.
Jarvis WR. Jarvis WR. Infect Control Hosp EpidemiolInfect Control Hosp Epidemiol 1996;17: 552-7 1996;17: 552-7
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Importance of Healthcare-Importance of Healthcare-associated infectionsassociated infections
The burden of Healthcare-associated infectionsThe burden of Healthcare-associated infections ((HAIs) is substantial in developed countries, where it HAIs) is substantial in developed countries, where it affects from 5% to 15% of hospitalized patients in affects from 5% to 15% of hospitalized patients in regular wards, and as many as 50% or more of regular wards, and as many as 50% or more of patients in intensive care units (ICUs).patients in intensive care units (ICUs).
The incidence of HAIs is between 25% and 40% in The incidence of HAIs is between 25% and 40% in developing countries.developing countries.
HAIsHAIs increase length of stay in hospital.increase length of stay in hospital. HAIsHAIs increase costs.increase costs. HAIsHAIs increase mortality.increase mortality.
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Points of This TalkPoints of This Talk
Incidence of HAI and costIncidence of HAI and cost Pharmacoeconomical analysisPharmacoeconomical analysis Excess costExcess cost Excess cost in HAIExcess cost in HAI Cost of antibioticsCost of antibiotics Extra length of stay Extra length of stay Extra mortalityExtra mortality
Dickema DJ, et al. Dickema DJ, et al. JAMAJAMA 2008;299:1190-2 2008;299:1190-2Hassan M, et al. Hassan M, et al. Hospital TopicsHospital Topics 2010;88:82-9 2010;88:82-9
Study designStudy design Patient group (incidence,prevalence,epidemics)Patient group (incidence,prevalence,epidemics) Location (hospital, follow-up after discharge)Location (hospital, follow-up after discharge) Dimension of the study (hospital, country, Dimension of the study (hospital, country,
Extra cost and design of length of stayExtra cost and design of length of stay Costs (hospital charges, deaths, antibiotics Costs (hospital charges, deaths, antibiotics
Dr BL Kapur Memorial Hospital, New Delhi, India, 2006 24 patients and 48 controls Excess hospitalization: 11,6 days Excess hospitalization: 11,6 days (p(p<< 0.0001) 0.0001)
Kothari A, et al. Kothari A, et al. J Hosp InfectJ Hosp Infect 2009;71:143-8 2009;71:143-8
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Central catheter-related Central catheter-related bloodstream infectionsbloodstream infections
Six ICU, Buenos Aires, Argentina, 1997-2002Six ICU, Buenos Aires, Argentina, 1997-2002 142 patients, 142 controls142 patients, 142 controls Excess hospitalization: 11,9 days Excess hospitalization: 11,9 days Excess mortality: 24,6 %Excess mortality: 24,6 % Excess cost: Excess cost: $$4,8884,888 Excess antibiotics cost: Excess antibiotics cost: $$1,9131,913
Rosenthal VD, et al. Rosenthal VD, et al. Am J Infect ControlAm J Infect Control 2003;31:475-80 2003;31:475-80
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Central venous catheter-associated Central venous catheter-associated
bloodstream infections (ICU)bloodstream infections (ICU) General Hospital, Specialties Intituto Mexicano del General Hospital, Specialties Intituto Mexicano del Seguro Social Hospital, Gabriel Mancera Hospital, Seguro Social Hospital, Gabriel Mancera Hospital, Mexico City, Mexico, 2002-3Mexico City, Mexico, 2002-3
Extra mortality in healthcare-Extra mortality in healthcare-associated infections (%)associated infections (%)
Study Year Country Mortality rate
Spengler RF 1978 USA 32,1
French GL 1991 Hong Kong 7,4
Dinkel RH 1994 USA 4,1
Yalcin AN 1997 Turkey 16,7
Martin M 2001 Spain 21,3
Sanchez-V LD 2006 Mexico 16,3
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Economical analysis studies in Economical analysis studies in Healthcare-associated infectionsHealthcare-associated infections
Use of guidelines for authors and editors on Use of guidelines for authors and editors on conducting an economic analysis,conducting an economic analysis,
Continued development of more sophisticated Continued development of more sophisticated mathematical models,mathematical models,
Training of infection control professionals in Training of infection control professionals in economic methods ……economic methods ……
Stone PW, et al. Stone PW, et al. Am J Infect ControlAm J Infect Control 2005; 33:501-9 2005; 33:501-9