Abstract:
INTRODUCTION:Hospital Acquired Infections (HAIs) are considered to be one of the most serious patient safety issues in healthcare today. It has been shown that HAIs contribute significantly not only to morbidity and mortality, but also to excessive costs for the health care system and for hospitalized patients. Since possibilities of prevention and control exist, hospital quality can be improved while simultaneously the cost of care is reduced. The objectives of this study were to examine the prevalence and the excess costs associated with HAIs. METHODS:A retrospective observational study was performed to estimate costs associated with hospital-acquired infections in Belgian hospitals, both in procedural admissions and in medical admissions. Hospital, diagnosis-related group, age and gender were used as matching factors to compare stays associated with HAIs and stays without HAIs. Data were obtained from the Minimum Basic Data Set 2008 used by Belgian hospitals to register case-mix data for each admission to obtain reimbursement from the authorities. Data included information from 45 hospitals representing 16,141 beds and 2,467,698 patient stays. Using the 2008 national feedback programme of the Belgian government, cost data were collected (prolonged length of stay, additional pharmaceuticals and procedures) and subsequently linked to the data set. By means of a sensitivity analysis we estimated potential monetary savings when a reduction in the incidence of HAIs in hospitals having a higher rate of hospital-acquired infections in comparison to other hospitals would be realized. RESULTS:In our sample 5.9% of the hospital stays were associated with a hospital-acquired infection. In the procedural admission subset this was the case for 4.7% of the hospital stays. The additional mean cost of the hospital-acquired infection was Euro 2,576 for all stays (P < 0.001) and Euro 3,776 for procedural stays (P < 0.001). The total burden of disease in Belgium is estimated at Euro 533,076,110 for all admissions and Euro 235,667,880 for the subset of procedural admissions. The excess length of stay varied between hospitals from 2.52 up to 8.06 days (Md 4.58, SD 1.01), representing an associated cost of Euro 355,060,174 (66.61% of the total cost). The cost of additional medical procedures and additional pharmaceutical products was estimated at Euro 62,864,544 (11.97%) and Euro 115,151,939 (21.60%) respectively. Overall, our results showed that considerable variability between hospitals regarding the incidence of HAIs (3.77-9.78%) for all hospital stays is present, indicating a potential for improvement. We provide a full overview of the potential monetary savings when reductions in HAIs are realized by applying different thresholds. For instance, if all Belgian hospitals having a higher rate of hospital-acquired infections improve their rate to the level of the hospital corresponding to percentile 75 (= 7.5% HAL) savings would be Euro 17,799,326. CONCLUSION:HALs are associated with important additional healthcare costs. Although not all hospital-acquired infections can be prevented, an opportunity to increase cost-effectiveness of hospital care delivery presents itself. This study is the first to estimate the annual economic burden of HALs for Belgium at a national level, incorporating all associated hospital costs. Apart from the fact that the cost of prolonged length of stay is of major importance, we have also shown that the cost of additional procedures and pharmaceutical products cannot be neglected when estimating the financial burden of HAIs.
journal_name
Acta Clin Belgjournal_title
Acta clinica Belgicaauthors
Trybou J,Spaepen E,Vermeulen B,Porrez L,Annemans Ldoi
10.2143/ACB.3258subject
Has Abstractpub_date
2013-05-01 00:00:00pages
199-205issue
3eissn
1784-3286issn
2295-3337journal_volume
68pub_type
杂志文章abstract::Abnormal endothelial function plays a pivota role in the pathogenesis of diabetic complications. Due to lack of autoregulation of glucose transport in the presence of high extracellular glucose concentrations, intracellular hyperglycaemia induces a series of metabolic changes that ultimately lead to the genesis of bot...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2007.017
更新日期:2007-03-01 00:00:00
abstract::A patient with severe rheumatoid arthritis received d-penicillamine treatment for 16 months. She developed mild pruritus 6 months after d-penicillamine initiation, and severe pemphigus 10 months after d-penicillamine was changed to azathioprine. Subsequent methylprednisolone pulse therapy resulted in a transient clini...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1080/17843286.1990.11718059
更新日期:1990-01-01 00:00:00
abstract::Although giant cell arteritis, also called temporal arteritis, is the most common primary vasculitis in the elderly, an association with AA amyloidosis has rarely been reported. AA amyloidosis is a disorder that results from the extracellular deposition of proteolytic cleavage products of serum amyloid A, which occurs...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2020.1763671
更新日期:2020-05-12 00:00:00
abstract::Insight into the fundamental physiological mechanisms of blood vessel development and neoformation has led to the discovery of multiple angiogenic growth factors and inhibitors. To date, at least 5 angiogenesis inhibitors are readily available for clinical use, mainly in the treatment of cancers and age-related macula...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2007.027
更新日期:2007-05-01 00:00:00
abstract::Within the scope of an information campaign of the Belgian Institute for Road Safety an attempt was made to classify 179 medicinal drugs from 9 therapeutic groups, listed in the Belgian "Commented Repertory of Drugs--1997", according to their effect on driving performance. The categorisation was based on literature da...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::Almost all epidemiologic studies have shown that the age-adjusted incidence of osteoporotic hip fracture has been increasing during the last decades. Although the age-related bone loss is considered to be a crucial determinant of the incidence of hip fracture, spontaneous fractures appear to be uncommon: about 90% of ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.1993.11718306
更新日期:1993-01-01 00:00:00
abstract::The last two decades have witnessed that flow-assisted analysis of in vitro-activated basophils can constitute a valuable adjunct in the in vitro diagnostic approach of immediate drug hypersensitivity reactions (IDHR). This article summarises the current experience with the basophil activation test in the diagnosis of...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1080/17843286.2015.1122871
更新日期:2016-02-01 00:00:00
abstract::Case report We report the case of a young Cameroonian woman who presented with cough, hyperthermia, weight loss, pancytopenia, and hepatosplenomegaly. A positive HIV serology was discovered and a chest radiography revealed a 'miliary pattern'. Bone marrow aspiration pointed out yeast inclusions within macrophages. Giv...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1080/17843286.2017.1376454
更新日期:2018-10-01 00:00:00
abstract::Temocillin, a methoxy-derivative of the broad-spectrum penicillin, ticarcillin, has been introduced into clinical practice in Belgium in 1988. Since then, not many surveys of its in vitro activity have been published. This study addresses this issue in a prospective collection of 300 consecutive Gram-negative isolates...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2001.053
更新日期:2001-11-01 00:00:00
abstract::The authors report the case of a 67-year-old woman, with mitral valve prolapse, for more than 20 years. She recently complained of attacks of syncope and clinical ventricular tachycardia; ventricular fibrillation was induced during programmed stimulation. The patient seemed to be at high risk for sudden cardiac death,...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::We present the case of a 51-year-old woman who presented a right supraclavicular mass corresponding to lymphadenitis with atypical mycobacterium (Mycobacterium genavense). Later, she developed subcutaneous purulent small nodules containing the same germ. The presence of this mycobacterium was in the context of recurre...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/0001551213Z.00000000016
更新日期:2014-04-01 00:00:00
abstract::We report on a 34-year-old woman, who was recently diagnosed with Von Hippel-Lindau disease (VHL), genetically confirmed. At this moment, she presented with an acute history of arterial hypertension, headache, cortical blindness and epilepsy. On the basis of clinical and magnetic resonance imaging (MRI) criteria the d...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2010.060
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVES:The comprehensive geriatric assessment (CGA) can detect geriatric problems and potentially improve survival, physical, and cognitive state of patients, as well as increase an older person's chances of staying at home longer. In older people, the number and severity of comorbidity increase with age and are an...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2016.1153816
更新日期:2016-08-01 00:00:00
abstract::Azole antifungals are a group of fungistatic agents that can be administered orally or parenterally. The determination of the concentrations of these antifungals (miconazole, fluconazole, ketoconazole, posaconazole, voriconazole, itraconazole, and its major active metabolite, hydroxy-itraconazole) in serum can be usef...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/0001551213Z.00000000018
更新日期:2014-01-01 00:00:00
abstract::Objectives: Behçet's disease (BD) is a multi-systemic inflammatory disorder which can affect all types and sizes of vessels.The usage of TNF-α antagonists is increasing in different involvements of BD that is inadequately controlled by standard immunosuppressive regimens. Methods: Here we reported a rare BD case that ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1080/17843286.2018.1522020
更新日期:2019-10-01 00:00:00
abstract::Acute kidney injury (AKI) is a common and serious complication in the intensive care setting. It seldom occurs in isolation, but is mostly part of a multiple organ dysfunction syndrome. The pathogenesis is frequently multifactorial, with sepsis contributing to 50% of the cases.The development of AKI in critically-ill ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2007.033
更新日期:2007-07-01 00:00:00
abstract::Infection with hepatitis B virus has become a vaccine-preventable disease. The recombinant hepatitis B vaccines available today are safe and immunogenic. In order for these vaccines to eradicate HBV a universal vaccination of neonates and/or children needs to be implemented. Major obstacles on the road to global hepat...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2001.032
更新日期:2001-07-01 00:00:00
abstract::This study evaluated the performance of the stand-alone sediMAX conTRUST (77Elektronika, Budapest, Hungary) analyser as an alternative to microscopic analysis of urine. The validation included a precision, carry-over, categorical correlation and diagnostic performance study with manual phase-contrast microscopy as ref...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2016.1249999
更新日期:2017-04-01 00:00:00
abstract::The authors analyse the bacteriological data gathered by 100 successive tracheal Punctures and compare these results to those obtained by sputum cultures, which had either been collected by routine or when withdrawing the catheter for tracheal aspiration. This plain and not hazardous technique allows to draw the follo...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.1971.11716773
更新日期:1971-01-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Postprandial reactive hypoglycaemia (PRH) is a clinical syndrome characterized by the recurrence of symptomatic hypoglycaemia during postprandial periods. PRH remains a diagnostic challenge for clinicians, because of its atypical manifestations and low prevalence, especially in older persons. ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/2295333714Y.0000000026
更新日期:2014-08-01 00:00:00
abstract::Cystic fibrosis (CF) is one of the most common hereditary lung diseases. Pseudomonas aeruginosa (PA), Aspergillus fumigatus (AF) and Candida albicans (CA) are the principal bacterial and fungal pathogens in the airways of CF patients. The interactions of coexisting bacterial-fungal pathogens are of great interest. In ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2020.1852850
更新日期:2020-11-26 00:00:00
abstract::The development of secondary leukemia in donor cells after allogeneic stem cell transplantation is a rare event. We describe the occurrence of acute myeloid leukemia in donor cells 4 years after a stem cell transplantation for multiple myeloma. The multiple myeloma was relapsing at the time of the onset of acute myelo...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2006.016
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:We previously validated uHear™ to screen for hearing loss in older patients with cancer without a known hearing loss, as part of a comprehensive geriatric assessment (CGA). In view of low specificity, we tested a new modified uHear™ scoring system as described by Handzel. METHODS:Patients, aged ≥70 years, we...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2017.1392070
更新日期:2018-04-01 00:00:00
abstract::The in vitro activity of cefepime has been compared with that of cefotaxime, ceftazidime, aztreonam, and piperacillin against 1826 Enterobacteriaceae including 537 inducible Enterobacteriaceae (Enterobacter spp., Serratia spp., Citrobacter spp,. Morganella morganii) and 572 non-fermenters, including 401 Pseudomonas ae...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,多中心研究
doi:
更新日期:1996-01-01 00:00:00
abstract::Tramadol is a weak opioid with effects on adrenergic and serotonergic neurotransmission that is used to treat cancer pain and chronic non malignant pain. This drug was initiated in association with paroxetine and dosulepine hydrochloride in a tetraparetic patient with chronic pain. Fifty-six days after initiation of t...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.1996.11718509
更新日期:1996-01-01 00:00:00
abstract::Type 1 (insulin-dependent) diabetes mellitus is a frequent chronic disease that affects children as well as adults. The disease keeps a life-long burden on patients, their environment and society. Although still incompletely understood, its pathogenesis becomes progressively unravelled. Autoimmune phenomena play an im...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1080/17843286.1993.11718293
更新日期:1993-01-01 00:00:00
abstract::The immune system may be considered as a sensory organ able to respond to different kinds of danger signals that are not detected by nervous cells. The immune response is not autonomous but also regulated by the central and peripheral nervous system, as well as by neuropeptides, vitamin D and neuroendocrine axes such ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.2143/ACB.67.3.2062657
更新日期:2012-05-01 00:00:00
abstract::Gestational diabetes (GDM) is a frequent medical condition during pregnancy. GDM is associated with an increased risk of complications for both the mother and the baby during pregnancy and birth. Women with GDM also have an increased risk of developing type 2 diabetes later in life. Two large randomised intervention t...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.2143/ACB.67.4.2062669
更新日期:2012-07-01 00:00:00
abstract::In Belgium, individual laboratory and treatment data of all HIV-infected patients seen in the 9 AIDS Reference Centres and 7 AIDS Reference Laboratories are collected prospectively since 2006. We present here an analysis of patients recorded in the cohort database between 1st of January 2006 and 31st of December 2008....
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.2143/ACB.67.5.2062686
更新日期:2012-09-01 00:00:00
abstract::The use of heparin may be complicated by two types of thrombocytopenia (HAT): type I occurs early, is transient, and has no clinical relevance, while type II may lead to very severe manifestations (arterial or venous thromboses and more rarely bleedings), that are still underestimated by some clinicians. HAT-type II m...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1080/17843286.1995.11718474
更新日期:1995-01-01 00:00:00