Definizione di un modello per la sicurezza ambientale in ospedale attraverso le attività del Servizio di Igiene Ospedaliera: risultati di una Budget Impact Analysis atta a stimare il risparmio legato alle infezioni evitate in un Policlinico Universitario.

[Autom. eng. transl.] Background Targeted environmental monitoring is necessary to ensure safety in the hospital. This is why the Hospital Hygiene Service (SIO) of the Gemelli General Hospital periodically examines 10 health production processes (PPS) and expresses, in compliance with scientific evidence and current legislation, related health and hygiene safety opinions. The purpose of this study is to carry out an economic evaluation to estimate the potential financial benefits of the prevention of hospital infections (IO), thanks to the environmental control actions implemented by the SIO. Methods A Budget Impact Analysis (BIA) was carried out for the PPS (three-year period 2011-2013 and forecast for 2014 and 2015) assuming three SIO efficiency scenarios: in the first one this is constant, in the second it increases due to the increase in investments in the environmental monitoring and in the third it decreases due to the reduction of them. The variables used for the BIA include: number of PPS disbursed, samples controlled by the SIO, non-conformities resulting between 2011 and 2013, attack rate and unit cost of the relative IOs from the scientific literature. Results The results of the BIA show, in the scenario with constant efficiency, a saving of 30.2% in 2015 compared to the potential financial impact, due to the direct costs of infectious adverse events alone, of € 1,172,533 of 2011. In the scenario with greater efficiency the savings reach 31.5% and fall to 28.8% in the one where it has decreased. Conclusions The study shows how, in a well-structured organization such as a university hospital, it is essential and fruitful to implement control procedures and invest in targeted environmental monitoring. In this way it will be possible to optimize the IO Risk Management and guarantee a saving of financial resources, above all in a period of strong attention to the economic sustainability of health services. Further evaluations are necessary to highlight also the potential savings deriving from the prevention of non-infectious adverse events.