Economics and Preventing Healthcare Acquired Infection (eBook)

Nicholas Graves is a Senior Research Fellow in Health Economics at the School of Public Health, Queensland University of Technology.  He is also a Senior Lecturer in the Department of Infectious Diseases at the Princess Alexandra Hospital, Australia. William Jarvis is a well-known figure in infection control.  He was formerly Chief of the Epidemiology Branch at the CDC, as well as Director of the Hospital Infections Program at the CDC.  He is a past President of The Society for Healthcare Epidemiologists of America (SHEA), and is currently Vice-President of the Association for Professionals in Infection Control (APIC).  

Acknowledgments 5
Contents 6
List of Figures 10
List of Tables 12
List of Panels 14
Introduction 15
Reasons for Writing This Book 15
Audiences for the Book 19
Organization of the Book 20
Economics 23
1.1 A Broad View of Economics 23
1.2 The Building Blocks of Economics 25
1.3 Conclusions 39
Health Economics 40
Preview 40
2.1 Origins and Content of Health Economics 40
2.2 The Parts of Health Economics Most Useful for Infection- Control 43
2.3 Competing Approaches to Economic Appraisal 45
2.4 Advantages and Disadvantages of Each Type of Economic Appraisal 49
2.5 Conclusions 50
Economic Appraisal: A General Framework 51
3.1 What an Economic Appraisal Looks Like 51
3.2 Incremental Analysis 55
3.3 Ceiling Ratios and Choosing Healthcare Programs 58
3.4 Conclusions 60
Economic Appraisal: The Nuts and Bolts 61
Preview 61
4.1 Using a Clinical Trial vs. a Modeling Study 61
4.2 Building a Model 64
4.3 Important Features of an Economic Appraisal 75
4.4 Conclusions 77
Changes Arising from the Adoption of Infection Control Programs 78
Preview 78
5.1 Overview of the Major Changes 78
5.2 Changes to the Number of Infections 81
5.3 Conclusions 86
Measuring the Cost of Healthcare Acquired Infections 87
Preview 87
6.1 Why Data on the Cost of HAI are Useful 87
6.2 Defining and Measuring Costs of HAI 88
6.3 Estimating the Increase in Length of Stay due to HAI 98
6.4 Conclusions 106
Measuring the Cost of Implementing Infection Control Programs 107
Preview 107
7.1 Estimating the Costs of Infection Control Programs 107
7.2 Two Case Studies for Estimating the Cost of Infection Control 108
7.3 Analyzing Costs, Inputs, and Outputs 111
7.4 Capital Costs 116
7.5 Conclusions 117
Preventing HAI and the Health Benefits that Result 118
Preview 118
8.1 Health Benefits 118
8.2 What QALYs are and How they are Estimated 118
8.3 Information Required to Estimate QALYs 125
8.4 Conclusions 131
Dissecting a Published Economic Appraisal 132
Preview 132
9.1 Economic Evaluation in the Infection Control Literature 132
9.2 Case Study of a Decision to Adopt Antimicrobial Central Venous Catheters 133
9.3 Structuring the Evaluation 133
9.4 Evidence Required for the Evaluation 137
9.5 Evaluating the Decision 141
9.6 Handling Uncertainty in the Decision 142
9.7 Interpreting the Results for Decision Making 145
9.8 Conclusions 146
Economic Facts and the Infection Control Environment 147
Preview 147
10.1 The Changing Infection Control Environment 147
10.2 The Economic Facts 149
10.3 Incentives for Bad Behavior 156
10.4 Good Decision Making for Infection Control 157
10.5 Conclusions 160
Appendix 161
References 163
Index 169