BURDEN - Burden of resistance and disease in European nations

EC contribution: : € 1.139.412
Duration: : 36 months
Starting date: : 01/07/2007
Funding scheme: : N/A
Keywords: : antimicrobial resistance, nosocomial infections, outcomes, hospital costs, European hospitals, infection control policies, cost-effectiveness, economic costs, economics of resistance, statistical methods
Contract/Grant agreement number: : 2005203
Project web-site: : http://www.eu-burden.info/

Background:

The emergence and spread of antimicrobial resistance (AMR) has become a major public health threat, and infections caused by antimicrobial resistant pathogens continue to increase in the European Union and worldwide. These infections cause suffering, incapacity and death, and impose an enormous financial burden on both healthcare systems and on society in general, because of direct costs due to prolongation of illness and treatment in hospital, indirect costs due to loss of productivity, and societal costs due to morbidity and mortality. This is likely to lead to already-scarce healthcare resources being diverted to infection control efforts, and will have long-term implications due to loss of confidence in the medical profession and in the public healthcare delivery system provided or regulated by governments. Therefore, the aim of this project is to provide realistic estimates of the burden of disease and the costs to societies attributable to infections caused by antimicrobial resistant pathogens in member states and accession countries of the European Union.

Problem:

There is a lack of data on the treatment outcomes in infections due to antibiotic resistant pathogens, in terms of attributable mortality, prolongation of hospital care and, above all, on the economic consequences for individuals and health-care systems and societies. Due to a wide variety of health care systems in Europe it is difficult to compare information from individual studies carried out in different countries.This information, however, is a prerequisite for estimating the burden of resistance and disease not only for individual countries but for Europe in general, and is essential to empower health system managers, policy-makers, public health specialists and health-care workers to understand, prioritize, develop and implement solutions in relation to competing health threats.

Aim:

The general objective of this project is to provide realistic estimates of the burden of disease and the costs attributable to infections caused by antimicrobial resistant pathogens in Member States and Accession Countries of the European Union.

The main specific objectives are:

To generate country-specific cost models for quantifying the economic loss due to AMR
To determine the excess mortality, morbidity, length of stay and costs attributable to AMR on the basis of calculations made from hospital data gathered in at least 15 hospitals and 200 ICUs in different European countries (incl. the influence of delay in appropriate therapy)
To illustrate the financial impact of AMR on care in European hospitals; besides this, to estimate the human and societal dimensions of infections caused by resistant pathogens and the repercussions for the health care systems, e.g. loss of confidence in the medical profession.

To achieve this, BURDEN will run in close cooperation with existing networks in the area of AMR and will, in the context of the above projects, constitute an important new cornerstone and generate the data which are still missing on the costs to societies. Data from at least 15 hospitals in different member states, and from a total of around 200 intensive care units located in more than 20 EU member states including Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, France, Finland, Germany, Greece, Great Britain, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden will be collected and analysed. The project will be carried out for 3 years (2007-2009). Additionally individual case histories of the human and social burden of infections caused by antimicrobial resistant bacteria will be surveyed.

Expected and obtained results:

Identification, on a country-by-country basis, of information needs of different stakeholders (public health experts, policy makers, politicians, health care system managers) for their own assessment of the burden of infectious diseases caused by antimicrobial susceptible and resistant bacterial pathogens
Generation of country-specific cost models for quantifying the economic loss due to AMR
Identification of incentives and counterincentives that impinge on efforts to control the spread of AMR
Determination of the excess mortality, morbidity, length of hospital stay and costs attributable to AMR on the basis of calculations made from data gathered in approximately 15 hospitals and 200 ICUs in different European countries (incl. the influence of delay in appropriate therapy)
Identification of best infection control practices and antimicrobial drug use programmes to keep costs caused by AMR to a minimum
Provision of direct feedback on the individual performance of the participating hospitals
Forecast of trends of AMR by extrapolating data available over the last six years for participating countries participating in EARSS and HELICS/IPSE
Illustration of the financial impact of AMR on care in European hospitals
Demonstration of the human and societal dimensions of infections caused by resistant pathogens and the repercussions for the health care systems, e.g. loss of confidence in hospitals, by presentation of individual case histories

At the end of the second project year, a first summary report on the financial impact of AMR on European hospital care, and the human and societal dimensions, will be presented. The final results will be presented to the European Parliament at the end of the third project year.

Potential applications:

The collection of data on the burden of disease and AMR will provide valid data for politicians, policy-makers and public health experts that will allow estimates of the burden and the costs of AMR on a national level allow a comparison of costs between countries of the European Region give recommendations for participating countries/hospitals for implantation effective measures to keep costs caused by AMR to a minimum inform public health authorities throughout Europe, in order to prioritise and plan future health political goals, as against other specific causes of morbidity and mortality in Europe.

Coordinator:

Prof. Dr Uwe Frank
University Hospital Freiburg
Institute of Environmental Medicine and Hospital Epidemiology
Freiburg, Germany
Tel. +49 761 270 8210
uwe.frank@uniklinik-freiburg.de

European Commission