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Economics and Preventing Healthcare Acquired Infection


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Table of Contents

Acknowledgements.- Introduction.- Chapter 1. Economics.- A broad view of economics .- The building blocks of economics.- The concept of scarcity.- The concept of opportunity cost.- The concept of efficiency.- The concept of competitive markets.- The concept of market failure.- The concept of economic appraisal.- Conclusions.- Chapter 2. Health Economics.- Origins and content of health economics.- The parts of health economics most useful for infection-control.- Competing approaches to economic appraisal.- Welfarism.- Extra-welfarism.- Advantages and Disadvantages of each type of economic appraisal.- Conclusions.- Chapter 3. Economic appraisal: a general framework.- What an economic appraisal looks like.- Incremental Analysis .- Ceiling ratios and choosing health care programs.- Conclusions.- Chapter 4. Economic appraisal: the nuts and bolts.- Using a clinical trial versus a modeling study.- Economic appraisal alongside clinical trials.- Economic appraisal by modeling study.- Building a model .- Objective One - Define the structure of the model.- Objective Two - Find the evidence required to make the decision.- Objective Three - Evaluate the model that has been designed .- Objective Four - Account for heterogeneity & uncertainty.- Objective Five - Value future research .- Important features of an economic appraisal.- Conclusions.- Chapter 5. Changes arising from the adoption of infection control programs.- Overview of the major changes.- Changes to the number of infections.- Epidemiological studies.- Synthesizing existing evidence.- Conclusions.- Chapter 6 - Measuring the cost of Healthcare Acquired Infections.- Why data on the cost of HAI are useful.- Defining and measuring costs of HAI .- The cost accountant's method.- The economist's method.- Differences between the cost accounting and economicsmethods.- Estimating the increase in length of stay due to HAI .- Design approaches.- Statistical approaches.- Conclusions.- Chapter 7. Measuring the cost of implementing infection control programs.- Estimating the costs of Infection Control programs.- Two case studies for estimating the cost of infection control.- A case study of the costs of adopting antimicrobial catheters.- A case study of the costs of a staff education program.- Analyzing costs, inputs and outputs.- Incremental costs.- Average Costs.- Cost data and decision making.- Capital costs.- Conclusions.- Chapter 8. Preventing HAI and the health benefits that result .- Health benefits.- What QALYs are and how they are estimated.- Information required to estimate QALYs.- The risk of death due to infection.- The nature of the health states and the methods for finding utility scores that describe them.- Conclusions.- Chapter 9. Dissecting a published economic appraisal.- Economic evaluation in the infection control literature.- Case study of a decision to adopt antimicrobial central venous catheters.- Structuring the evaluation.- Evidence required for the evaluation.- Epidemiological parameters.- Effectiveness of antimicrobial CVCs.- Costs.- Health outcomes.- Evaluating the decision.- Handling uncertainty in the decision.- Parameter uncertainty.- Data quality.- Generalizability.- Interpreting the results for decision making.- Conclusions.- Chapter 10. Economic facts and the infection control environment.- The changing infection control environment .- The economic facts.- Diminishing returns.- Cost structures.- Lack of good information .- Incentives for bad behavior.- Conclusion.

About the Author

Nicholas Graves is a Senior Research Fellow in Health Economics at the School of Public Health, Queensland University of Technology. He is also a Senior Lecturer in the Department of Infectious Diseases at the Princess Alexandra Hospital, Australia. William Jarvis is a well-known figure in infection control. He was formerly Chief of the Epidemiology Branch at the CDC, as well as Director of the Hospital Infections Program at the CDC. He is a past President of The Society for Healthcare Epidemiologists of America (SHEA), and is currently Vice-President of the Association for Professionals in Infection Control (APIC).


From the reviews: "This book on the cost of healthcare-associated infectious is written from an economic rather than an accounting perspective, a difference that is explained in detail ! . It is written for infection-control personnel and infectious disease practitioners with no prior knowledge of economics. ! Graduate and professional students and researchers in health-related fields with an interest in healthcare epidemiology may find this book a helpful introduction. ! it is easy to read and clearly organized." (Linnea A. Polgreen, Doody's Review Service, August, 2009)

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