ABSTRACT
Accurately estimating the economic costs to hospitals and society has proven challenging because of difficulties in both developing standard economic methods to accurately measure the excess or attributable costs of resistant infections and understanding the epidemiology of drug resistance. This chapter reviews the methods of measuring the direct excess or attributable hospital patient cost resulting from acquiring an antimicrobial resistant organism from the cost perspective of the hospital. The failure of market prices to represent opportunity cost is particularly true for the consumption of antimicrobials. Opportunity costs associated with drug resistant hospital-associated infection are usually expressed in terms of alternative uses within the hospital. Infected patients have a perspective on cost similar to that of physicians, because the patient’s focus is on successful treatment. The chapter concludes with some recommendations to improve the quality of the economic information that can be provided by hospital-based observational studies and their use in economic evaluations of antimicrobial resistance in hospitals.
