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Chapter ID: CBB760923391

Cleanliness costs: the evolving relationship between infection and length of stay in antibiotic-era hospitals (2021)

Sheard, Sally (Author)

Manchester University Press
Pages: 51-78
Publication date: 2021
Language: English

ISBN: 9781526140784

DOI: https://doi.org/10.7765/9781526140791.00012

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Antibiotics Infectious diseases Patients Hospitals and clinics 21st century 20th century

Hospital acquired infection (HAI] - referred to as ‘nosocomial’ infection in US terminology - emerged as a specific policy concern in the mid-twentieth century, although it has a much longer lineage. This chapter uses a comparative Anglo-American perspective to repositions the debate on the history of HAIs, which has to date been focused on scientific understanding of infection through the use of evolutionary paradigms, the development of new approaches such as clinical epidemiology and the enduring fascination with the discovery, use and abuse of antibiotics and associated rise of antimicrobial resistance (AMR). Some of this historical research has marginalised or ignored (by choice or ignorance) the key issue that health care is an economic, as well as a scientific-clinical activity. These lacunae are particularly evident when historians discuss how responses to HAIs resulted in the formation of protocols and teams, which they invariably articulate as comprised of clinical/technical staff (surgeons, physicians, nurses, microbiologists and epidemiologists). There has been minimal recognition that hospital administrators and managers could (and did) play key roles in these developments because of the significant and increasing impact of HAIs on hospital costs, arising in part through concerns about length of patient stay, and through the roles of insurance companies in the Unites States and economists at national policymaking levels in the UK. (Publisher)

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Book Anne Marie Rafferty; Marguerite Dupree; Fay Bound Alberti (2021) Germs and governance: The past, present and future of hospital infection, prevention and control. unapi

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