Economic burden of antibiotic resistance in China: a national level estimate for inpatients
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 patie...
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| Format: | Article |
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BMC
2021-01-01
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| Series: | Antimicrobial Resistance and Infection Control |
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| Online Access: | https://doi.org/10.1186/s13756-020-00872-w |
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| author | Xuemei Zhen Cecilia Stålsby Lundborg Xueshan Sun Nina Zhu Shuyan Gu Hengjin Dong |
| author_facet | Xuemei Zhen Cecilia Stålsby Lundborg Xueshan Sun Nina Zhu Shuyan Gu Hengjin Dong |
| author_sort | Xuemei Zhen |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-24T05:04:37Z |
| format | Article |
| id | doaj.art-157dab8279634b8b8e7186e7a08c4316 |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-24T05:04:37Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-157dab8279634b8b8e7186e7a08c43162022-12-21T17:13:51ZengBMCAntimicrobial Resistance and Infection Control2047-29942021-01-011011910.1186/s13756-020-00872-wEconomic burden of antibiotic resistance in China: a national level estimate for inpatientsXuemei Zhen0Cecilia Stålsby Lundborg1Xueshan Sun2Nina Zhu3Shuyan Gu4Hengjin Dong5Center for Health Policy Studies, School of Public Health, Zhejiang University School of MedicineDepartment of Global Public Health, Karolinska InstitutetCenter for Health Policy Studies, School of Public Health, Zhejiang University School of MedicineNational Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Healthcare Associated Infections and Antimicrobial Resistance (HCAIs & AMR), Department of Infectious Disease, Imperial CollegeCenter for Health Policy Studies, School of Public Health, Zhejiang University School of MedicineCenter for Health Policy Studies, School of Public Health, Zhejiang University School of MedicineAbstract 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.https://doi.org/10.1186/s13756-020-00872-wAntibiotic resistanceMulti-drug resistanceEconomic burdenInpatientChina |
| spellingShingle | Xuemei Zhen Cecilia Stålsby Lundborg Xueshan Sun Nina Zhu Shuyan Gu Hengjin Dong Economic burden of antibiotic resistance in China: a national level estimate for inpatients Antimicrobial Resistance and Infection Control Antibiotic resistance Multi-drug resistance Economic burden Inpatient China |
| title | Economic burden of antibiotic resistance in China: a national level estimate for inpatients |
| title_full | Economic burden of antibiotic resistance in China: a national level estimate for inpatients |
| title_fullStr | Economic burden of antibiotic resistance in China: a national level estimate for inpatients |
| title_full_unstemmed | Economic burden of antibiotic resistance in China: a national level estimate for inpatients |
| title_short | Economic burden of antibiotic resistance in China: a national level estimate for inpatients |
| title_sort | economic burden of antibiotic resistance in china a national level estimate for inpatients |
| topic | Antibiotic resistance Multi-drug resistance Economic burden Inpatient China |
| url | https://doi.org/10.1186/s13756-020-00872-w |
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