The economic inpact of nosocomial infection on hospital management

为了明确医院感染对医院管理的经济影响，我们研究了综合医院（114个床位）耐甲氧西林金黄色葡萄球菌（MRSA）检测和治疗的费用，以及耐甲氧西林金黄色葡萄球菌（MRSA）感染控制所需的费用。该研究的对象是15名住院期间感染MRSA的患者和负责照顾他们的几名护理人员。15例患者经背景检查，年龄60 ~ 94岁（平均79岁），伴有糖尿病、脑血管疾病、心脏病等。此外，他们大多因肺炎入院治疗，并发MRSA肺炎。MRSA感染控制的总成本是根据每位患者每天的消耗性用品的总和、每位患者每天的护士工资以及患者在隔离室的平均天数来计算的。包括隔离室额外费用在内的消耗性用品费用为每位患者每天19,070日元，护士的工资为每位患者每天2,214日元。平均隔离期为75天，因此计算出每位患者控制MRSA感染的总费用为160万日元。由于这一年有46例新的耐甲氧西林金黄色葡萄球菌感染病例，这一年的总费用为7300万日元。每位患者的MRSA感染检测和治疗费用为130万日元，全年总费用为6000万日元。综上所述，MRSA感染患者的管理需要许多未出现在临床护理费用中的费用。还显示，由于隔离，无法获得普通的私人病房费用，这对医院的管理产生了很大的影响。在未来，我们希望评估预防老年肺炎患者MRSA感染的措施。少

In order to clarify the economic impact of nosocomial infection on hospital management, we studied the cost of MRSA testing and treatment, and concomitantly the costs necessary to cover methicillin-resistant Staphylococcus aureus (MRSA) infection control in general hospital (114beds).The subjects of the study were 15 patients infected with MRSA during the hospital stay and several members of the nursing staff charged with their care. Examination of the background of the 15 patients showed that they were elderly, ranging in age from 60 to 94 years (mean age ; 79 years), and that they were bedfast with diabetes mellitus, cerebrovascular disease, or heart disease, etc. In addition, most of them had been admited for treatment of pneumonia, and developed MRSA pneumonia as a complication.Total cost for MRSA infection control was calculated from the sum of expendable suppulies per patient per day, from a nurse's wages per patient per day, and from the average duration in days of a patient's s … More tay in an isolation room.The sum of expendable supplies, including extra charge for an isolation room, was 19,070 yen per patient per day, and the nurse's wages 2,214 yen per patient per day. The average isolation period was 75 days, such that the total cost for MRSA infection control was calculated to be 1.6 million yen per patient. Since there were 46 new cases of MRSA infection during the year, the total cost for the year was 73 million yen.The cost of the testing and treatment for MRSA infection was 1.3 million yen per patient, making the total cost for the year was 60 million yen.Based on the above findings, it was learned that many costs which do not appear in the clinical care fees are needed in the management of MRSA infected patients. It was also exhibited thath the ordinary private room charge is not obtained because of isolation, and that this has a great impact on hospital management. In the future we would like to assess measures for preventing MRSA infection in elderly pneumonia patients. Less