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Infektioner i slutenvård: Omfattning och kostnader i Östergötland – en pilotstudie
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
2013 (Swedish)Report (Other academic)
Abstract [sv]

Vårdrelaterade infektioner (VRI) är ett allt mer uppmärksammat problem inom sjukvården. Ungefär 10 procent av alla inneliggande patienter i Sverige antas bli drabbade av en VRI men variationen är stor mellan de medicinska specialiteterna. Denna studie är explorativ och syftar i första hand till att presentera en modell för att beräkna merkostnader för sjukvården som är relaterade till VRI. Materialet består dels av den Punktprevalensmätning (PPM) som genomfördes i Östergötland 2011 och dels de uppgifter från Landstingets Vårddatalager som var aktuellt för de patienter som var inneliggande de dagar då PPM genomfördes.

Det förelåg en stark korrelation mellan de registrerade riskfaktorerna och uppkomsten av en VRI. De två mest förekommande riskfaktorerna var ”Kirurgiskt ingrepp” och ”KAD” (kvarliggande urinkateter). Antalet vårddagar var dubbelt så många för de som drabbats av en VRI på ett antal inkluderade enheter jämfört de som inte drabbats (25 dagar vs 13 dagar). Kostnaderna per patient var i det fallet mer än dubbelt så höga för de drabbade patienterna jämfört med de som inte drabbades (331 000 kronor jämfört med 145 000 kronor). Inga skillnader i ålder kunde noteras mellan grupperna.

De patienter som drabbades av en VRI på de i studien inkluderade enheterna på Universitetssjukhuset utgjorde en fjärdedel av antalet patienter (24 %) men de stod för 40 procent av de totala vårdkostnaderna. Motsvarande andelar för hela länet var att 16 procent av antalet patienter hade en specificerad infektion och dessa patienter stod för 30 procent av de totala kostnaderna. Ifall antalet patienter som drabbas av en VRI kunde reduceras med en tredjedel eller upp till hälften så skulle det på sikt vara teoretiskt möjligt att överlag reducera de totala vårdkostnaderna för sluten sjukhusvård med mellan 4 – 12 procent.

Pilotstudien gav begränsade möjligheter att analysera materialet i detalj och därför har en studie med flera års data från PPM ihop med registeruppgifter från Vårddatalagret startats.

Abstract [en]

Healthcare-associated infections (HAI) is an increasingly recognized problem in health care. Approximately 10 percent of all hospitalized patients in Sweden is expected to be hit by a HAI but there is considerable variation between the medical specialties. This study is exploratory and aims primarily to present a model to estimate the additional costs for medical care related to HAI. The material consists of the Point Prevalence Survey (PPM) which was conducted in Östergötland in 2011 and also the information from the County Council's Health Care register that was current for the patients who were hospitalized on days when PPM was conducted.

There was a strong correlation between the recorded risk factors and the occurrence of an HAI. The two most prevalent risk factors were "Surgery" and "KAD" (indwelling urinary catheter) . The number of hospital days were twice as many compared to those not affected (25 days vs. 13 days) for those affected by a HAI on a number of included units. The cost per patient in that case was more than twice as high for the affected patients compared with those who were not affected ( SEK 331,000 compared with SEK 145,000). No age differences were noted between the groups.

The patients who suffered a HAI on the included units of the University Hospital was one quarter of patients (24%) but these patients accounted for 40 percent of the total health care costs. The corresponding proportions for the entire county was that 16 percent of the patients had a certain infection and these patients accounted for 30 percent of the total costs. If the number of patients who suffer from a HAI could be reduced by one-third, or up to half of all recent cases, it would be theoretically possible to reduce total overall healthcare costs for inpatient care with between 4-12 percent.

The pilot study resulted in limited opportunities to analyze the material in detail and therefore have a study with several years of data from the PPM together with records from Health Care register started.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2013. , 33 p.
Series
CMT Report, ISSN 0283-1228 (print), 1653-7556 (online) ; 2013:3
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-103039ISRN: LIU CMT RA/1303OAI: oai:DiVA.org:liu-103039DiVA: diva2:686057
Available from: 2014-01-10 Created: 2014-01-10 Last updated: 2014-01-10

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Rahmqvist, Mikael

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