[Medico-economic analysis of nosocomial infections]

The purpose of this study was to examine analyses of the micro-economic and macro-economic consequences of hospital-acquired nosocomial infections.

We performed a critical analysis of the methods reported in the literature for economic estimations of the cost of nosocomial infections and determined the objectives that can be assigned to them.

Macro-economic estimations of the consequences of nosocomial infections clearly have methodological limitations but nevertheless have an important impact since concern about global cost of nosocomial infections is a persuasive argument in favor of prevention programs. Studies based on calculating the estimated mean cost by type of nosocomial infection cannot alone provide a sufficiently reliable data to determine the pertinence of preventive strategies. Cost-efficiency studies (cost per year of saved life, or cost per nosocomial infection avoided) appear to be more adapted.

One must carefully examine the underlying methodology when using cost-efficacy ratios associated with different strategies as a decision-making tool.