title: Healthcare associated infections in Paediatric Intensive Care Unit of a tertiary care hospital in India: Hospital stay & extra costs.
abstract: OBJECTIVE
  Healthcare associated infections (HAIs) increase the length of stay in the hospital and consequently costs as reported from studies done in developed countries. The current study was undertaken to evaluate the impact of HAIs on length of stay and costs of health care in children admitted to Paediatric Intensive Care Unit (PICU) of a tertiary care hospital in north India.
  
  
  METHODS
  This prospective study was done in the seven bedded PICU of a large multi-specialty tertiary care hospital in New Delhi, India. A total of 20 children with HAI (cases) and 35 children without HAI (controls), admitted to the PICU during the study period (January 2012 to June 2012), were matched for gender, age, and average severity of illness score. Each patient's length of stay was obtained prospectively. Costs of healthcare were estimated according to traditional and time driven activity based costing methods approach.
  
  
  RESULTS
  The median extra length of PICU stay for children with HAI (cases), compared with children with no HAI (controls), was seven days (IQR 3-16). The mean total costs of patients with and without HAI were ' 2,04,787 (US$ 3,413) and ' 56,587 (US$ 943), respectively and the mean difference in the total cost between cases and controls was ' 1,48,200 (95% CI 55,716 to 2,40,685, p<0.01).
  
  
  CONCLUSIONS
  This study highlights the effect of HAI on costs for PICU patients, especially costs due to prolongation of hospital stay, and suggests the need to develop effective strategies for prevention of HAI to reduce costs of health care.
authors.affiliation: Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Jitender
authors.initials: J
authors.lastname: Sodhi
authors.affiliation: Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sidhartha
authors.initials: S
authors.lastname: Satpathy
authors.affiliation: Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: D K
authors.initials: DK
authors.lastname: Sharma
authors.affiliation: Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Lodha
authors.affiliation: Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Arti
authors.initials: A
authors.lastname: Kapil
authors.affiliation: Paediatric Biology Centre, Translational Health Science & Technology Institute, Gurgaon, India.
authors.forename: Nitya
authors.initials: N
authors.lastname: Wadhwa
authors.affiliation: Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Shakti Kumar
authors.initials: SK
authors.lastname: Gupta
mesh_terms: D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000191:economics / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D007194:India; D015278:Intensive Care Units, Pediatric / Q000191:economics*; D007902:Length of Stay / Q000191:economics; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000191:economics / Q000453:epidemiology* / Q000382:microbiology; D062606:Tertiary Care Centers / Q000191:economics*