, Volume 39, Issue 3, pp 185–199 | Cite as

Costs of hospital-acquired infection and transferability of the estimates: a systematic review

  • H. Fukuda
  • J. Lee
  • Y. ImanakaEmail author


Hospital-acquired infections (HAIs) present a substantial problem for healthcare providers, with a relatively high frequency of occurrence and considerable damage caused. There has been an increase in the number of cost-effectiveness and cost-savings analyses of HAI control measures, and the quantification of the cost of HAI (COHAI) is necessary for such calculations. While recent guidelines allow researchers to utilize COHAI estimates from existing published literature when evaluating the economic impact of HAI control measures, it has been observed that the results of economic evaluations may not be directly applied to other jurisdictions due to differences in the context and circumstances in which the original results were produced. The aims of this study were to conduct a systematic review of published studies that have produced COHAI estimates from 1980 to 2006 and to evaluate the quality of these estimates from the perspective of transferability. From a total of 89 publications, only eight papers (9.0%) had a high level of transferability in which all components of costs were described, data for costs in each component were reported, and unit costs were estimated with actual costing. We also did not observe a higher citation level for studies with high levels of transferability. We feel that, in order to ensure an appropriate contribution to the infection control program decision-making process, it is essential for researchers who estimate COHAI, analysts who use COHAI estimates for decision-making, as well as relevant journal reviewers and editors to recognize the importance of a transferability paradigm.


Hospital-acquired infection Costs Transferability Costing method 



This work was supported by a Grant-in-Aid for the Japan Society for the Promotion of Science (JSPS) Fellows and a Health Sciences Research Grant from the Ministry of Health, Labour and Welfare of Japan.

Conflict of interest

We certify that there is no actual or potential conflict of interest in relation to this article.


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© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Institute for Health Economics and PolicyTokyoJapan
  2. 2.Department of Healthcare Economics and Quality Management, School of Public Health, Graduate School of MedicineKyoto UniversityKyotoJapan

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