How do we evaluate the cost of nosocomial infection? The ECONI protocol: an incidence study with nested case-control evaluating cost and quality of life

Sally Stewart, Chris Robertson, Sarkis Manoukian, Lynne Haahr, Helen Mason, Agi McFarland, Stephanie Dancer, Brian Cook, Nicholas Graves, Jacqui Reilly

Research output: Contribution to journalArticle

Abstract

Introduction Healthcare-associated or nosocomial infection (HAI) is distressing to patients and costly for the National Health Service (NHS). With increasing pressure to demonstrate cost-effectiveness of interventions to control HAI and notwithstanding the risk from antimicrobial-resistant infections, there is a need to understand the incidence rates of HAI and costs incurred by the health system and for patients themselves. Methods and analysis The Evaluation of Cost of Nosocomial Infection study (ECONI) is an observational incidence survey with record linkage and a nested case-control study that will include postdischarge longitudinal follow-up and qualitative interviews. ECONI will be conducted in one large teaching hospital and one district general hospital in NHS Scotland. The case mix of these hospitals reflects the majority of overnight admissions within Scotland. An incidence survey will record all HAI cases using standard case definitions. Subsequent linkage to routine data sets will provide information on an admission cohort which will be grouped into HAI and non-HAI cases. The case-control study will recruit eligible patients who develop HAI and twice that number without HAI as controls. Patients will be asked to complete five questionnaires: the first during their stay, and four others during the year following discharge from their recruitment admission (1, 3, 6 and 12 months). Multiple data collection methods will include clinical case note review; patient-reported outcome; linkage to electronic health records and qualitative interviews. Outcomes collected encompass infection types; morbidity and mortality; length of stay; quality of life; healthcare utilisation; repeat admissions and postdischarge prescribing. Ethics and dissemination The study has received a favourable ethical opinion from the Scotland A Research Ethics Committee (reference 16/SS/0199). All publications arising from this study will be published in open-access peer-reviewed journal. Lay-person summaries will be published on the ECONI website. Trial registration number NCT03253640; Pre-results.

LanguageEnglish
Article numbere026687
Number of pages10
JournalBMJ Open
Volume9
Issue number6
DOIs
Publication statusPublished - 19 Jun 2019

Fingerprint

Cost Control
Cross Infection
Cohort Studies
Quality of Life
Scotland
Costs and Cost Analysis
National Health Programs
Case-Control Studies
Incidence
Interviews
District Hospitals
Electronic Health Records
Diagnosis-Related Groups
Research Ethics Committees
Infection
Ethics
Teaching Hospitals
General Hospitals
Health Care Costs
Cost-Benefit Analysis

Keywords

  • case-control study
  • healthcare associated infection
  • incidence
  • infection control
  • mortality
  • quality of life

Cite this

Stewart, Sally ; Robertson, Chris ; Manoukian, Sarkis ; Haahr, Lynne ; Mason, Helen ; McFarland, Agi ; Dancer, Stephanie ; Cook, Brian ; Graves, Nicholas ; Reilly, Jacqui. / How do we evaluate the cost of nosocomial infection? The ECONI protocol : an incidence study with nested case-control evaluating cost and quality of life. In: BMJ Open. 2019 ; Vol. 9, No. 6.
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How do we evaluate the cost of nosocomial infection? The ECONI protocol : an incidence study with nested case-control evaluating cost and quality of life. / Stewart, Sally; Robertson, Chris; Manoukian, Sarkis; Haahr, Lynne; Mason, Helen; McFarland, Agi; Dancer, Stephanie; Cook, Brian; Graves, Nicholas; Reilly, Jacqui.

In: BMJ Open, Vol. 9, No. 6, e026687, 19.06.2019.

Research output: Contribution to journalArticle

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AU - Stewart, Sally

AU - Robertson, Chris

AU - Manoukian, Sarkis

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