Cost analysis of hospital infections associated with invasive devices in a university hospital

Background and Aims: In terms of human health, besides the losses it causes, healthcare-associated infections (HCAI) are an important public health problem due to additional costs. However, the area is'nt sufficiently studied in Turkey. In this study, the relation between the device-associated infections and the costs related with the patients in the intensive care unit (ICU) of the Istanbul Medical Faculty, Department of Anesthesiology and Reanimation was evaluated. In addition, costs from the perspective of the hospital and Social Security Institution and additional mortality attributed to infection with different cost analysis perspectives, additional cost outcomes were also compared. Materials and Methods: The data of 700 hospitalizations, which were treated between January 1, 2016 and December 31, 2018 in the relevant ICU and collected by the Hospital Infection Control Committee of Istanbul Medical Faculty , were analyzed for the analysis of device-associated infections costs with a retrospective cohort type design. For the analysis, direct medical costs were taken from the hospital perspective. Comparison of device-associated infections presence and cost with other variables was done with the whole patient group and one-to-one matching. Analyzes were made with case-control groups that emerged as a result of one-to-one matching; as well as all of the unpaired hospitalizations. In addition, hospitalizations diagnosed with HI have been analyzed separately. Direct standardization method was used to calculate the daily cost of hospitalization by controlling the length of HCAI diagnosed hospitalizations and this is the first study using standardization technique on costs. Results: In device-associated infection diagnosed hospitalizations, the length of hospitalization and the costs were found to be high with a significant difference. HCAI, device-associated infection, ventilator-associated pneumonia (VAP), central lineassociated bloodstream ınfection (CLABSI) and catheter-associated urinary tract ınfection (CAUTI) hospitalizations, respectively; "The total length of hospitalization for single diagnose" are 33,7, 34,4, 48,2, 27,3 and 27,8 days, while "additional hospitalization length" are 15,8, 16,2, 23,6, 14,0 and 13,2 days. On the other hand, "average hospitalization costs" are $ 10,540, $ 11,286, $ 13,537, $ 10,377 and $ 13,794 4 respectively. As a result of one-to-one matching, these costs decrease slightly, but there is a significant difference. And the standardized daily costs, regardless of the hospitalization length; It has been calculated as $ 191.23, $ 196.81, $ 159.18, $ 302.20 and $ 463.04. Conclusion: The economic effects of device-associated infection are serious. The fact that decision makers evaluate the situation over opportunity costs and increase their support for infection control programs carried out by infection control committees is important in terms of human health as well as the monetary aspect of health services.