OBJECTIVES: Studies from around the world have shown hospital acquired infections (HAI) increase the costs of medical care, morbidity and mortality. However, there is paucity of data on the economic burden of HAIs in India.

METHODS: MEDLINE was systematically searched, pairing relevant keywords to identify English language articles describing outcomes in clinical studies.

RESULTS: The study by Chacko, 2017 showed that when compared with those who did not develop an infection, an infection occurring during ICU stay was associated with significantly higher treatment cost [median (inter-quartile range, IQR) Rs. 92,893 (IQR 57,168 to 1,40,286) vs Rs. 1,80,469 (IQR 1,40,030 to 2,37,525); P < 0.001. The study by Kothari, 2009 showed that cost was significantly more (mean: US $14,818 (~Rs. 9,61,547.43); 95% CI: 6,91,927.40 to12,31,298.76; P < 0.0001) in cases than controls. Sodhi, 2009 showed that mean total costs of patients with and without HAI were Rs. 2,04,787 and Rs. 56,587, respectively and the mean difference in the total cost between cases and controls was Rs.1,48,200 (95% CI 55,716 to 2,40,685, P<0.01). Joyce, 2009 showed that total expenses incurred by those affected by SSIs was Rs. 29,000 (average) as compared to Rs. 16,000 (average) by those who were not affected by SSI. Tiwari, 2013 showed that cases had a cost of Rs. 704,175 ± 57,804 (12,803 ± 1,051) vs. controls Rs. 1,44,106 ± 15,614 (2,620 ± 284). Moreover, drugs’ acquisition costs, rent, consultation fees, investigation costs, and antimicrobial costs were significantly higher for cases than for controls (P< 0.001). Drugs’ acquisition cost was the major contributor of the extra cost, and antimicrobial drugs constituted almost half of it.

CONCLUSIONS: The evidence synthesis demonstrates discernible economic burden of HAI management in India. Continuous surveillance and prophylaxis could reduce the burden of HAIs in India.