Potential economic burden of carbapenem-resistant Enterobacteriaceae (CRE) in the United States.
Potential economic burden of carbapenem-resistant Enterobacteriaceae (CRE) in the United States.
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DOI：
10.1016/j.cmi.2016.09.003
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发表时间：
2017-01
期刊：
影响因子：
--
通讯作者：
Lee BY
中科院分区：
文献类型：
--
作者：
Bartsch SM;McKinnell JA;Mueller LE;Miller LG;Gohil SK;Huang SS;Lee BY
疾病控制和预防中心认为碳青霉烯类耐药肠杆菌科（CRE）是一种紧迫的公共卫生威胁;然而，其经济负担尚不清楚。我们开发了一个CRE临床和经济学结果模型，以确定从医院，第三方支付者和社会角度来看CRE感染的成本，并评估CRE对美国的健康和经济负担。根据感染类型的不同，单一CRE感染的中位数费用范围为医院22 484美元至66 031美元，第三方支付者10 440美元至31 621美元，社会37 778美元至83 512美元。美国每10万人口中的感染率为2.93（9418例感染）将花费医院2.75亿美元（95% CR 2.17 - 3.34亿美元），第三方付款人1.47亿美元（95% CR 1.29 - 1.72亿美元）和社会5.53亿美元（95%CR 3.03 - 15.93亿美元），可归因死亡率为25%，并将导致8841（95%CR 5805- 12420）质量调整生命年的损失。发病率为15/100 000（48213例感染）将花费医院14亿美元（95% CR 11 - 17亿美元），第三方付款人8亿美元（95%CR $0.6-0.8十亿）和社会$2.8十亿（95%CR $1.6-8.2十亿），并导致45261质量调整生命年的损失。CRE的费用高于许多慢性病和许多急性病的年度费用。成本随CRE的发生率成比例地增加，对于每10万人6、10和15例的发生率，成本分别增加2.0倍、3.4倍和5.1倍。
The Centers for Disease Control and Prevention considers carbapenem-resistant Enterobacteriaceae (CRE) an urgent public health threat; however, its economic burden is unknown. We developed a CRE clinical and economics outcomes model to determine the cost of CRE infection from the hospital, third-party payer, and societal, perspectives and to evaluate the health and economic burden of CRE to the USA. Depending on the infection type, the median cost of a single CRE infection can range from $22 484 to $66 031 for hospitals, $10 440 to $31 621 for third-party payers, and $37 778 to $83 512 for society. An infection incidence of 2.93 per 100 000 population in the USA (9418 infections) would cost hospitals $275 million (95% CR $217–334 million), third-party payers $147 million (95% CR $129–172 million), and society $553 million (95% CR $303–1593 million) with a 25% attributable mortality, and would result in the loss of 8841 (95% CR 5805–12 420) quality-adjusted life years. An incidence of 15 per 100 000 (48 213 infections) would cost hospitals $1.4 billion (95% CR $1.1–1.7 billion), third-party payers $0.8 billion (95% CR $0.6–0.8 billion), and society $2.8 billion (95% CR $1.6–8.2 billion), and result in the loss of 45 261 quality-adjusted life years. The cost of CRE is higher than the annual cost of many chronic diseases and of many acute diseases. Costs rise proportionally with the incidence of CRE, increasing by 2.0 times, 3.4 times, and 5.1 times for incidence rates of 6, 10, and 15 per 100 000 persons.
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DOI：
10.1136/bmj.e8639
发表时间：
2013-01-08
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Bermingham SL;Hodgkinson S;Wright S;Hayter E;Spinks J;Pellowe C
通讯作者：
Pellowe C
影响因子：
4.5
作者：
Fitzpatrick M;Zembower T;Malczynski M;Qi C;Bolon MK
通讯作者：
Bolon MK
影响因子：
11.8
作者：
Falagas ME;Tansarli GS;Karageorgopoulos DE;Vardakas KZ
通讯作者：
Vardakas KZ
影响因子：
14.2
作者：
Capone, A.;Giannella, M.;Petrosillo, N.
通讯作者：
Petrosillo, N.
影响因子：
--
作者：
Eber, Michael R.;Laxminarayan, Ramanan;Malani, Anup
通讯作者：
Malani, Anup