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Table S1. Economic impact of HAIs. Tabella S1. Impatto economico delle ICA. Studies that estimate HAI costs Name of the study/first author, year of publication (ref) Main results With an annual incidence of 4.5 every 100 hospital admissions, the direct cost of HAIs is calculated to amount to about $4.5 billion every year 2
Plowman RP, 1997 , Mayor S, In England the annual incidence of HAIs is 1 million cases, with an attributable mortality of 3
2000 5,000 deaths and a total cost of more than £1 billion for the NHS SSIs, given their annual incidence and expected cost, rank first among adverse events for the 4
Rigby K, 1999 health system from an economic point of view -­‐ SSIs cost from $10,500 to $25,000 every year -­‐ Average attributable patient cost of Ventilator Associated Pneumonia (VAP) ranges from 5
Tambyah PA, 2002 , Warren DK, $11,897 to $25,072 6
7
2003 , Hu KK, 2004 , Stone PW, -­‐ Central Line Associated Blood Stream Infections (CLABSI) are associated with an average 8
9
2005 , Anderson DJ, 2007 , cost ranging from $5,700 to $22,900 10
Dubberke ER, 2008 -­‐ Every single Clostridium difficile infection costs from $5,000 to $7,000 -­‐ A Catheter Associated Urinary Tract Infection (CAUTI) costs from $600 to $758 with a total annual cost ranging from $340 to $450 million Prevention of 10% of HAIs could produce an additional reimbursement for hospitals in 11
Alliata E, 2004 Lombardia of about €21 million per year SSIs have an additional cost for every infection ranging from £960 for HAI following 12
Coello R, 2005 hysterectomy to £6,100 for SSI following limb amputation SSIs are the most expensive for national health systems with an annual cost ranging from $3 13
Klevens RM,2007 to $10 billion Every year, HAIs cause an increase of 16 million days of hospital stay, with an annual cost of 14
ECDC-­‐report 2008 €7 billion, not considering indirect costs such as loss of profit The annual cost of HAIs after adjustment by two different inflation indexes ranges from $28.4 15
CDC-­‐report, 2009 to $33.8 billion and from $35.7 to $45 billion depending on the inflation index used SSIs extend hospital stay by 9.7 days and increase cost by $20,842 per admission. SSIs are annually associated with an additional 406,730 hospital-­‐days and hospital costs exceeding 16
de Lissovoy G, 2009 $900 million. An additional 91,613 readmissions for SSI treatment accounted for a further 521,933 days of care at a cost of nearly $700 million A HAI that occurs in a medical ward is estimated to cost about €4,000 while a HAI acquired in 17
ASSOBIOMEDICA,2011 the ICU can cost up to €28,000, mainly due to the prolongation in the length of stay In Belgium 125,000 HAIs every year have a 2.8% mortality rate and cause an increase of LoS 18
Vrijens F, 2012 in hospitals of 7.3 days and a total annual cost for the NHS of €290 million Retrospective reports of actual outbreaks Main results 19
Yule BF, 1988 A salmonella outbreak in a Scottish hospital involved 243 people among healthcare workers, patients and visitors; the total cost of the outbreak was estimated to range from £200,000 to £900,000, including costs for infected people, health systems, and society 20
Barnass S, 1989 An outbreak of multi-­‐drug-­‐resistant Salmonella heidelberg in an English hospital in the late 1980s caused the infection of 19 people and cost about £21,000; 85% of this cost was borne by the hospital 21
Mahieu LM, 2001 The costs of HAIs in the neonatology unit of the teaching hospital of Antwerp from October 1993 to December 1995 were about €11,000 per patient 22
Stout JE, 2003 A hospital-­‐acquired Legionnaires’ disease outbreak in Los Angeles cost about $20 billion 23
Engemann JJ, 2005 Staphylococcus aureus bacteraemia among patients receiving long-­‐term haemodialysis in North Carolina cost $24,000 24
Bou R, 2009 The total attributable cost of a P. aeruginosa outbreak in the ICU of the Hospital de La Ribera (Valencia) was calculated to be €312,936, with an incremental hospital stay of 70 days. Every HAI cost €27,917, which exceeded by 66% (€18,408) the mean cost of a non-­‐HAI patient (€9,509) 1
SENIC project, 1980 References / Bibliografia 1. The SENIC Project. Study on the efficacy of nosocomial infection control. Am J Epidemiol 1980;111:472-­‐85. 2. Plowman RP, Graves N, Roberts JA. Hospital acquired infection. London: Office of Health Economics, 1997. 3. Mayor S. Hospital acquired infections kill 5000 patients a year in England. BMJ 2000;321:1370. 4. Rigby K, Clark RB, Runciman WB. Adverse events in health care: setting priorities based on economic evaluation. J Qual Clin Pract 1999;19:7-­‐12. 5. Tambyah PA, Knasinski V, Maki DG. The direct cost of nosocomial catheter-­‐associated urinary tract infection in the era of managed care. Infect Control Hosp Epidemiol 2002;23:27-­‐31. 6. Warren DK, Shukla DJ, Olsen MA, et al. Outcome and attributable cost of ventilator-­‐
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