Economic impact of nosocomial bacteraemia. A comparison of three calculation methods

Marta Riu, Pietro Chiarello, Roser Terradas, Maria Sala, Xavier Castells, Hernando Knobel, Francesc Cots

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

Abstract

© 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica Introduction The excess cost associated with nosocomial bacteraemia (NB) is used as a measurement of the impact of these infections. However, some authors have suggested that traditional methods overestimate the incremental cost due to the presence of various types of bias. The aim of this study was to compare three assessment methods of NB incremental cost to correct biases in previous analyses. Methods Patients who experienced an episode of NB between 2005 and 2007 were compared with patients grouped within the same All Patient Refined-Diagnosis-Related Group (APR-DRG) without NB. The causative organisms were grouped according to the Gram stain, and whether bacteraemia was caused by a single or multiple microorganisms, or by a fungus. Three assessment methods are compared: stratification by disease; econometric multivariate adjustment using a generalised linear model (GLM); and propensity score matching (PSM) was performed to control for biases in the econometric model. Results The analysis included 640 admissions with NB and 28,459 without NB. The observed mean cost was € 24,515 for admissions with NB and € 4,851.6 for controls (without NB). Mean incremental cost was estimated at € 14,735 in stratified analysis. Gram positive microorganism had the lowest mean incremental cost, € 10,051. In the GLM, mean incremental cost was estimated as € 20,922, and adjusting with PSM, the mean incremental cost was € 11,916. The three estimates showed important differences between groups of microorganisms. Conclusions Using enhanced methodologies improves the adjustment in this type of study and increases the value of the results.
Original languageEnglish
Pages (from-to)620-625
JournalEnfermedades Infecciosas y Microbiologia Clinica
Volume34
Issue number10
DOIs
Publication statusPublished - 1 Dec 2016

Keywords

  • Cost adjustment
  • Economic evaluation
  • Economic impact
  • Hospital costs
  • Nosocomial bacteraemia

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