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1.
Int J Hyg Environ Health ; 211(1-2): 192-9, 2008 Mar.
Article in English | MEDLINE | ID: mdl-17581784

ABSTRACT

For the presented study a computer-based surveillance system for detecting nosocomial infections (NI) with direct data input from attending on-ward physicians was implemented. During a 12-month period surveillance of ventilator-associated pneumonia (VAP) and catheter-associated bloodstream infections (BSI) was performed prospectively by on-ward physicians guided by infection control specialists on an 11-bed medical intensive care unit in a German university hospital. In 603 patients 3282 patient days were assessed. Completeness of data entry during the routine phase was 94% for ventilator days and 88% for central venous catheter days. The concordance of infection detection by automated evaluation and evaluation based clinical considerations was fairly good and was quantified by kappa measures of 0.49 for VAP and 0.57 for BSI. Detected infection rates ranged within the German national reference data. Personnel costs for on-ward physicians and infection control personnel were 1.01 Euro per device day in the routine phase. Time expenditure of less than 3 min per device day, rendered in about equal parts by physicians and infection control personnel, was lower than in studies relying on on-ward assessment by infection control personnel.


Subject(s)
Cross Infection/prevention & control , Decision Support Systems, Clinical , Equipment Contamination , Health Plan Implementation/economics , Population Surveillance/methods , Catheterization, Central Venous/adverse effects , Costs and Cost Analysis , Cross Infection/epidemiology , Cross Infection/etiology , Data Collection/methods , Decision Support Systems, Clinical/economics , Germany/epidemiology , Hospital Costs , Humans , Infection Control Practitioners/economics , Intensive Care Units , Physicians/economics , Pneumonia, Ventilator-Associated/epidemiology , Pneumonia, Ventilator-Associated/prevention & control , Prospective Studies , Sepsis/epidemiology , Sepsis/etiology , Sepsis/prevention & control
2.
Infect Control Hosp Epidemiol ; 24(9): 673-8, 2003 Sep.
Article in English | MEDLINE | ID: mdl-14510250

ABSTRACT

OBJECTIVE: To determine the added costs of hygienic measures (barrier precautions, isolation, and decontamination) required for MRSA carriers in German hospitals and possible strategies for cost reduction. DESIGN: On a septic surgical ward caring for 35% of all MRSA cases in a university hospital (1,182 beds), additional costs for personnel time and materials were calculated and medical charts of all MRSA cases admitted to the ward during 1 year were analyzed retrospectively. Twelve of the ward's 13 beds were located in rooms with at least 2 beds. PATIENTS: Four hundred ninety-eight MRSA carrier hospital-days (of 20 MRSA cases) could be assessed. All patients (80% men, 50% older than 74.5 years) had broken skin. RESULTS: In 95% of the cases, microbiological findings suggested transmission of MRSA during the current or a previous stay on this ward. The study found total avoidable costs of approximately 142,794.01 euros in 1 year, averaging 371.95 euros for one MRSA patient hospital-day and 9,261.56 euros per MRSA case. The most expensive single measure was blocked beds in multibed rooms (305.75 euros/day), which accounted for 82% of the extra costs. Costs most likely were underestimated. CONCLUSIONS: Daily additional case costs amounted to 96% of social security payments. Blocked beds in multibed rooms accounted for more than 80% of these excess costs. Isolation has been scientifically validated and is required by law in Germany. Building an adequate number of single-bed rooms should help prevent spread and would greatly lower the added costs of infection.


Subject(s)
Hospital Costs/statistics & numerical data , Infection Control/methods , Medical Audit , Methicillin Resistance , Staphylococcal Infections/drug therapy , Staphylococcal Infections/economics , Surgery Department, Hospital/economics , Aged , Cost Control , Costs and Cost Analysis , Female , Humans , Male , Middle Aged , Patient Isolation/economics , Staphylococcus aureus/drug effects , Staphylococcus aureus/pathogenicity
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