Predicting Potential Prevention Effects on Hospital Burden of Nosocomial Infections: A Multistate Modeling Approach.

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Derek HazardMartin Wolkewitz

Abstract

Hospital-acquired infections (HAIs) place a substantial burden on health systems. Tools are required to quantify the change in this burden as a result of a preventive intervention. We aim to estimate how much a reduction in the rate of hospital-acquired infections translates into a change in hospital mortality and length of stay. Using multistate modelling and competing risks methodology, we created a tool to estimate the reduction in burden after the introduction of a preventive effect on the infection rate. The tool requires as inputs the patients' length of hospital stay, patients' infection information (status, time), patients' final outcome (discharged alive, dead), and a preventive effect. We demonstrated the methods on both simulated data and 3 published data sets from Germany, France, and Spain. A hypothetical prevention that cuts the infection rate in half would result in 21 lives and 2212 patient-days saved in French ventilator-associated pneumonia data, 61 lives and 3125 patient-days saved in Spanish nosocomial infection data, and 20 lives and 1585 patient-days saved in German nosocomial pneumonia data. Our tool provides a quick and easy means of acquiring an impression of the impact a preventive measure would have o...Continue Reading

References

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May 4, 2006·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·J BeyersmannM Schumacher
Mar 16, 2011·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Adrian G BarnettMartin Wolkewitz
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Sep 17, 2013·International Journal of Epidemiology·Martin SchumacherMartin Wolkewitz
Mar 19, 2014·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Majken Linnemann JensenBendix Carstensen
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Jun 22, 2017·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Martin WolkewitzMartin Schumacher
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