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Why is it so difficult to take measures against infectious diseases ③

Antibiotic depletion

Antibiotics are commonly used to treat infections with drug-resistant bacteria.

In the case of Japan, unlike Europe and the United States, the medical system is covered by an insurance system, so when a hospital suffers from an infectious disease, the cost of treatment is not borne by the hospital, but is covered by the government. By the way, in most of Europe and the United States, if the infection is the responsibility of the hospital, it is covered by the cost of the hospital. The increase in medical expenses caused by MRSA hospital infection and hospital infection control has been published by the Japanese Society for Infection Control and Prevention Vol.28 no.5, 2013.

Recently, infectious diseases in Japan, including the United States, have been replaced by the term medical-related infections because they are no longer limited to hospitals. It was stated that the investigation of the infection rate of MRSA, etc. made it difficult to obtain patient information in Japan from the viewpoint of personal information protection, so a trial calculation was conducted based on past information. There are many resistant bacteria that pose a problem, but in Japan, about 80% are MRSA. The main reason for antibiotic depletion is that even if a pharmaceutical manufacturer develops a new antibiotic, drug resistance will soon increase. If possible, it is difficult to collect the research, so it is said that the main reason is that they are not willing to do the research.

◎ Aggregation of 5 facilities (based on the results

  of the 2008 survey)

・Estimated increase in average length of stay

due to MRSA infection

・81.12 days → There were an average of 167 MRSA

cases at 5 facilities with 600 beds. That MRSA and that The average length of hospital stay for people with other infectious diseases is 81.12 days.

・15.05 days → There are 56,869 non-infection cases, and the average length of hospital stay is 15,05 days. ・66.07 days → The average extra hospital stay for one MRSA case is 66.07 days. ・¥ 58,744 → In the case of MRSA cases at 5 hospitals, the average treatment cost per person per day is ¥ 58,744.

・¥ 3,881,216.08 → If the treatment period (66.07 days) is extended, ¥ 58,744 × 66.07 days = ¥ 3,881,216.08 It costs treatment costs. ・Assuming that the occupancy rate of a hospital with 480 beds → 600 beds is 80%, 480 beds will operate when the occupancy rate is multiplied by 0.8. It will be there. ・71.01 people → Since the number of extra hospitalization days for all infectious diseases is 15.05 days for 365 days a year. 365 ÷ 15.05 = 24.25 rotations. (Operating rotation speed of 1 bed) 24.25 rotations x operating rate 80% = 19.40 rotations / 1 bed 1 year (19.40 people) 19.40 times x 600 beds = 11,641 people /year. Since 0.61% of this is MRSA 11,641 x 0.0061 = 71.01 people. ・0.61% → In addition, there are 255,642 cases of infection at 22 facilities / year,so MRSA cases are combined. The total is 1,561 cases, and the MRSA infection rate is 1561 / 255,642 = 0.0061 (0.61%). ・¥ 275,610,182.7 → Therefore,the treatment cost for MRSA cases per year at one hospital with 600 beds Total ¥ 3,881,216.08 x 600 beds x 0.8 (assuming bed occupancy rate 80%) x (365 ÷ 15.05) x 0.0061 (MRSA infection) Rate) = ¥ 275,610,182.7 yen. ◎In the case of counting of 22 facilities ・255,642 cases → Total number of inpatients at 22 facilities for one year ・11,620.09 cases → Total number of inpatients at one facility per year 255,643 cases / 22 facilities / year ÷ 22 facilities = 11,620.09 ・¥ 275,389,922.8 yen → ¥ 3,881,216.08 (Average treatment cost per MRSA) x 1,561 cases (22 facilities) Total MRSA case survey) ÷ 22 facilities = ¥ 275,389,922.8 yen (An extra cost of 1 MRSA case per year at one hospital with 600 beds). ◎Treatment costs that increase due to all-hospital infections (Nosocomial infections)(Hospital infection rate is estimated to be approximately 5%). Approximately ¥ 275,000,000 x (0.05 ÷ 0.0061) = Approximately ¥ 2,254,000,000 Regarding various nosocomial infections, one hospital facility with 600 beds costs extra treatment costs for hospital-acquired cases annually. The total will be ¥ 2,254,000,000. Japanese Society for Infection Control and Prevention Vol.28 no.5, 2013 Materials written by Hiroyoshi Kobayashi, a professor at Tokyo Health Care University Graduate School, etc. [Reference: In the case of the United States] -At least 1/4 of the patients in the ICU in the world are hospital-acquired. -In the United States, nosocomial infections are 2.5 million people / year and deaths are 90,000 people /year (3.6%). 247 people / day per day -5-10% of inpatients in US hospitals have nosocomial infections each year. (1 in 10 to 20 people) Nosocomial infections are the sixth leading cause of death in the United States. -Hospital-acquired pneumonia infection is low under highly specialized nurses. -The mortality rate of ventilator-related pneumonia is about 10-40%. Estimated cost starts from $ 30,000 per case 40,000 (¥ 3-4 million). According to one document, the economic loss is $ 12,780 (¥ 1.2 million) per case. -The mortality rate due to nosocomial pneumonia is 15% to 18%. Incidence rate is 5 to 15 / 1,000 days of hospitalization

-The average length of stay can be increased by up to 4 to 14 days, and the cost of taking out the hospital is $ 2 billion (¥ 200 billion). -Hand disinfection is the most important factor to prevent the spread of infectious diseases. By doing it correctly, the colony shape The unit of formation can be reduced by 90%. It can also reduce antibiotic resistance by 33%.

             Development status of antibiotics in US

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