The impact of nosocomial infections on hospital care costs

Estimating costs due to nosocomial infection (NI) requires the incremental costs associated with NI diagnosis and treatment must be distinguished from those attributable to the management of the original healthcare problems. We carried out a review of the analyses of additional costs resulting from NIs and the evaluation of the methods used to estimate these costs, in order to perform a cost benefit analysis of NI prevention activities. Characteristics of additional costs for main NIs were initially considered. Secondly, a review of methods for estimating the incremental costs was performed. Finally, a cost effectiveness analysis of NI prevention activities was performed. Few studies estimated the incidence of NIs and assessed the economic burden they cause. Investigators generally estimated only direct additional costs. Implicit physician assessment, unmatched group comparison, matched control and appropriateness evaluation protocol (AEP)-based methods are the methodologies used to estimate incremental days of stay due to NIs. Different studies show possible benefits, in terms of health and cost savings, when hospital-acquired infections are prevented. However, there is a need for further studies to evaluate in greater detail the variables related to costs attributable to these infections and to enhance the control strategies. Moreover, a structured surveillance and control program of NI is the single most effective tool for prevention.