Xuemei Zhen1,2, Cecilia Stålsby Lundborg3, Xueshan Sun1, Nina Zhu4, Shuyan Gu1,5, Hengjin Dong6,7. 1. Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China. 2. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, (NHC Key Laboratory of Health Economics and Policy Research), Shandong University, Jinan, 250012, China. 3. Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden. 4. National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Healthcare Associated Infections and Antimicrobial Resistance (HCAIs & AMR), Department of Infectious Disease, Imperial College, London, UK. 5. Center for Health Policy and Management Studies, Nanjing University, Nanjing, China. 6. Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China. donghj@zju.edu.cn. 7. The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, China. donghj@zju.edu.cn.
Abstract
BACKGROUND: Antibiotic resistance (AR) threats public health in China. National-level estimation of economic burden of AR is lacking. We aimed to quantify the economic costs of AR in inpatients in China. METHODS: We performed a multicentre and retrospective cohort study including 15,990 patient episodes at four tertiary hospitals in China from 2013 to 2015 to assess the impact of AR on hospital mortality, length of stay, and costs. We estimated the societal economic burden of AR using findings from the cohort study and secondary data from national surveillance hubs and statistical reports. RESULTS: Patients with multi-drug resistant (MDR) infection or colonisation caused by Staphylococcus aureus, Enterococcus faecalis, Enterococcus faecium, Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, and Acinetobacter baumannii experienced higher individual patient cost ($3391, 95% uncertainty interval (UI) $3188-3594), longer hospital stay (5.48 days, 95% UI 5.10-5.87 days), and higher in-hospital mortality rates (1.50%, 95% UI 1.29-1.70%). In China, 27.45% of bacterial infection or colonisation that occurred in inpatients were resistant, of which 15.77% were MDR. A societal economic burden attributed to AR was estimated to be $77 billion in 2017, which is equivalent to 0.37% of China's yearly gross domestic product, with $57 billion associated with MDR. CONCLUSIONS: This is the first study to estimate national-level economic burden of AR in China. AR places a significant burden on patient health and healthcare systems. Estimation of economic costs of resistant infection or colonisation is the essential step towards building an economic case for global and national actions to combat AMR.
BACKGROUND: Antibiotic resistance (AR) threats public health in China. National-level estimation of economic burden of AR is lacking. We aimed to quantify the economic costs of AR in inpatients in China. METHODS: We performed a multicentre and retrospective cohort study including 15,990 patient episodes at four tertiary hospitals in China from 2013 to 2015 to assess the impact of AR on hospital mortality, length of stay, and costs. We estimated the societal economic burden of AR using findings from the cohort study and secondary data from national surveillance hubs and statistical reports. RESULTS:Patients with multi-drug resistant (MDR) infection or colonisation caused by Staphylococcus aureus, Enterococcus faecalis, Enterococcus faecium, Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, and Acinetobacter baumannii experienced higher individual patient cost ($3391, 95% uncertainty interval (UI) $3188-3594), longer hospital stay (5.48 days, 95% UI 5.10-5.87 days), and higher in-hospital mortality rates (1.50%, 95% UI 1.29-1.70%). In China, 27.45% of bacterial infection or colonisation that occurred in inpatients were resistant, of which 15.77% were MDR. A societal economic burden attributed to AR was estimated to be $77 billion in 2017, which is equivalent to 0.37% of China's yearly gross domestic product, with $57 billion associated with MDR. CONCLUSIONS: This is the first study to estimate national-level economic burden of AR in China. AR places a significant burden on patient health and healthcare systems. Estimation of economic costs of resistant infection or colonisation is the essential step towards building an economic case for global and national actions to combat AMR.
Authors: Min Jiang; Bin Sun; Yong Huang; Chengyang Liu; Yan Wang; Yanli Ren; Yuhong Zhang; Yunying Wang; Di Mu Journal: Infect Drug Resist Date: 2022-08-18 Impact factor: 4.177