Micro-économie de l'infection nosocomiale
Institution:
Lyon 3Disciplines:
Directors:
Abstract EN:
This work has been realized in lyon which is the second largest hospital structure in france in two departments of abdominal surgery for one year and in prospective. 15,4 per cent of the sick have been infected and the cost of this infection amounts to 16. 994 french francs on average per patient 1978, that is an 80 per cent rate of increase (37. 138 20. 144) for infected sick patients as compared with non infected ones. The microeconomic infection cost includes not only invoiced postoperative hospital cost (stay, examinations, medical treatment) but also the post hospital cost, valued from the studied medical consumption angle during the six months after coming out of hospital (new hospital admissions, care, examinations, pharmacy, convalescence home). Another type of non invoiced post operative medical hospital cost valued from a difference in intensity of care between infected sick patients and non infected sick ones : this type of cost comes in addition to invoiced cost. The invoiced social cost worked out from wages paid completes the microeconomical infection cost notion. In relation to previously published international studies, this work presents a particularity in the approach of invoiced medical postoperative hospital cost and non invoiced medical postoperative cost.
Abstract FR:
Ce travail a ete realise a lyon, seconde structure hospitaliere francaise dans deux services de chirurgie abdominale, pendant une duree d'une annee et en propectif. 15,4% des malades ont ete infectes et le cout de l'infection s'eleve en moyenne et par malade a la somme de 16 994 francs 1978 soit un accroissement de 80 pourcents (37138 20144) pour les malades infectes par rapport a ceux qui ne le sont pas. Le cout micro-economique de l'infection comprend non seulement le cout hospitalier post-operatoire facture (sejours, examens, actes), mais egalement le cout posthospitalier apprecie du point de vu des consommations medicales etudiees pendant une duree de six mois apres la sortie de l'hopital (rehospitalisations, examens, pharmacie, maisons de repos). Un autre type de cout, le cout medical hospitalier post-operatoire non facture, est evalue a partir d'une difference dans l'intensite des soins entre les malades infectes et ceux qui ne le sont pas : il vient s'ajouter au cout facture. Le cout social calcule a partir des salaires verses vient completer la notion de cout micro-economique de l'infection. Par rapport aux etudes internationales deja publiees, ce travail presente une particularite par l'approche qui est faite du cout medical post-hospitalier facture et du cout medical hospitalier post-operatoire non facture.