[Setting priorities in the prevention and control of nosocomial infections: an economic perspective]
Nosocomial infections are a good indicator of the quality of health care provided by hospitals. Despite their cost-effectiveness, nosocomial infection programs are rarely applied in Italy. Epidemiological surveillance is the simplest measure to adopt because it allows us to monitor the baseline endemic rates, identify new epidemics and assess the improvements achieved by interventions provided. The presence of continuous epidemiological surveillance must be considered the exception rather than the rule in Italy. In this paper, the prevention of nosocomial infections was analysed through two economic evaluation techniques (i.e. cost-benefit and cost effectiveness). A hierarchy of intervention based on cost effectiveness, hospital size and organisational setting was also provided. The main conclusions are the following: 1. Benefits associated to prevention of nosocomial infections are considered small because of the uncertainty associated to the future. Therefore a discount factor must be applied. 2. Local factors and specific reasons are usually advocated to explain the simple fact that infection control programs are only formally implemented and usually limited to the constitution of a nosocomial infections committee. 3. The prevention of nosocomial infections must be provided for under specific laws which take into account the various organisations and structures found in different hospitals.
Tramarin
A.
A
Divisione Malattie Infettive, Ospedale San Bortolo, Vicenza, Italy.
Bragagnolo
L.
L
Scagnelli
M.
M
De Lalla
F.
F
Definizione delle priorita e degli obiettivi nei programmi di prevenzione e controllo delle infezioni ospedaliere: il punto di vista economico.