Modeling the costs of hospital-acquired infections in New Zealand.
OBJECTIVE
To model the economic costs of hospital-acquired infections (HAIs) in New Zealand, by type of HAI.


METHODS
Monte Carlo simulation model.


METHODS
Auckland District Health Board Hospitals (DHBH), the largest publicly funded hospital group in New Zealand supplying secondary and tertiary services. Costs are also estimated for predicted HAIs in admissions to all hospitals in New Zealand.


METHODS
All adults admitted to general medical and general surgical services.


METHODS
Data on the number of cases of HAI were combined with data on the estimated prolongation of hospital stay due to HAI to produce an estimate of the number of bed days attributable to HAI. A cost per bed day value was applied to provide an estimate of the economic cost. Costs were estimated for predicted infections of the urinary tract, surgical wounds, the lower and upper respiratory tracts, the bloodstream, and other sites, and for cases of multiple sites of infection. Sensitivity analyses were undertaken for input variables.


RESULTS
The estimated costs of predicted HAIs in medical and surgical admissions to Auckland DHBH were dollar 10.12 (US dollar 4.56) million and dollar 8.64 (US dollar 3.90) million, respectively. They were dollar 51.35 (US dollar 23.16) million and dollar 85.26 (US dollar 38.47) million, respectively, for medical and surgical admissions to all hospitals in New Zealand.


CONCLUSIONS
The method used produces results that are less precise than those of a specifically designed study using primary data collection, but has been applied at a lower cost The estimated cost of HAIs is substantial but only a proportion of infections can be avoided. Further work is required to identify the most cost-effective strategies for the prevention of HAI.
Graves
Nicholas
N
Centre for Health Care Related Infectious Surveillance and Prevention, Princess Alexandra Hospital, Queensland, Australia.
Nicholls
Tanya M
TM
Morris
Arthur J
AJ
D003365:Costs and Cost Analysis; D003428:Cross Infection / Q000191:economics*; D005544:Forecasting; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D018803:Models, Economic; D009010:Monte Carlo Method; D009520:New Zealand