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Rice S, Carr K, Sobiesuo P, Shabaninejad H, Orozco-Leal G, Kontogiannis V, Marshall C, Pearson F, Moradi N, O'Connor N, Stoniute A, Richmond C, Craig D, Allegranzi B, Cassini A. Economic evaluations of interventions to prevent and control health-care-associated infections: a systematic review. THE LANCET. INFECTIOUS DISEASES 2023; 23:e228-e239. [PMID: 37001543 DOI: 10.1016/s1473-3099(22)00877-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 11/23/2022] [Accepted: 12/14/2022] [Indexed: 03/30/2023]
Abstract
Almost 9 million health-care-associated infections have been estimated to occur each year in European hospitals and long-term care facilities, and these lead to an increase in morbidity, mortality, bed occupancy, and duration of hospital stay. The aim of this systematic review was to review the cost-effectiveness of interventions to limit the spread of health-care-associated infections), framed by WHO infection prevention and control core components. The Embase, National Health Service Economic Evaluation Database, Database of Abstracts of Reviews of Effects, Health Technology Assessment, Cinahl, Scopus, Pediatric Economic Database Evaluation, and Global Index Medicus databases, plus grey literature were searched for studies between Jan 1, 2009, and Aug 10, 2022. Studies were included if they reported interventions including hand hygiene, personal protective equipment, national-level or facility-level infection prevention and control programmes, education and training programmes, environmental cleaning, and surveillance. The British Medical Journal checklist was used to assess the quality of economic evaluations. 67 studies were included in the review. 25 studies evaluated methicillin-resistant Staphylococcus aureus outcomes. 31 studies evaluated screening strategies. The assessed studies that met the minimum quality criteria consisted of economic models. There was some evidence that hand hygiene, environmental cleaning, surveillance, and multimodal interventions were cost-effective. There were few or no studies investigating education and training, personal protective equipment or monitoring, and evaluation of interventions. This Review provides a map of cost-effectiveness data, so that policy makers and researchers can identify the relevant data and then assess the quality and generalisability for their setting.
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Affiliation(s)
- Stephen Rice
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
| | - Katherine Carr
- Dental School, Newcastle University, Newcastle upon Tyne, UK
| | - Pauline Sobiesuo
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Hosein Shabaninejad
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Giovany Orozco-Leal
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Christopher Marshall
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK; NIHR Innovation Observatory, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona Pearson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK; NIHR Innovation Observatory, Newcastle University, Newcastle upon Tyne, UK
| | - Najmeh Moradi
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Nicole O'Connor
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK; NIHR Innovation Observatory, Newcastle University, Newcastle upon Tyne, UK
| | - Akvile Stoniute
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine Richmond
- NIHR Innovation Observatory, Newcastle University, Newcastle upon Tyne, UK
| | - Dawn Craig
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK; NIHR Innovation Observatory, Newcastle University, Newcastle upon Tyne, UK
| | - Benedetta Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
| | - Alessandro Cassini
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
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Olmsted RN. Reimagining Construction and Renovation of Health Care Facilities During Emergence from a Pandemic. Infect Dis Clin North Am 2021; 35:697-716. [PMID: 34362539 PMCID: PMC8331249 DOI: 10.1016/j.idc.2021.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
The built environment has been integral to response to the global pandemic of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In particular, engineering controls to mitigate risk of exposure to SARS-CoV-2 and other newly emergent respiratory pathogens in the future will be important. Anticipating emergence from this pandemic, or at least adaptation given increasing administration of effective vaccines, and the safety of patients, personnel, and others in health care facilities remain the core goals. This article summarizes known risks and highlights prevention strategies for daily care as well as response to emergent infectious diseases and this parapandemic phase.
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Affiliation(s)
- Russell N Olmsted
- Integrated Clinical Services (ICS), Trinity Health, Mailstop W3B, 20555 Victor Parkway, Livonia, MI 48152, USA.
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Squire MM, Munsamy M, Lin G, Telukdarie A, Igusa T. Modeling hospital energy and economic costs for COVID-19 infection control interventions. ENERGY AND BUILDINGS 2021; 242:110948. [PMID: 33814682 PMCID: PMC7997299 DOI: 10.1016/j.enbuild.2021.110948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 03/13/2021] [Accepted: 03/19/2021] [Indexed: 05/10/2023]
Abstract
The study objective assessed the energy demand and economic cost of two hospital-based COVID-19 infection control interventions: negative pressure (NP) treatment rooms and xenon pulsed ultraviolet (XP-UV) equipment. After projecting COVID-19 hospitalizations, a Hospital Energy Model and Infection De-escalation Models quantified increases in energy demand and reductions in infections. The NP intervention was applied to 11, 22, and 44 rooms for small, medium, and large hospitals, while the XP-UV equipment was used eight, nine, and ten hours a day. For small, medium, and large hospitals, the annum kWh for NP rooms were 116,700 kWh, 332,530 kWh, 795,675 kWh, which correspond to annum energy costs of $11,845 ($1,077/room), $33,752 ($1,534/room), and $80,761 ($1,836/room). For XP-UV, the annum-kilowatt-hours (and costs) were 438 ($45), 493 ($50), and 548 ($56) for small, medium, and large hospitals. While energy efficiencies may be expected for the large hospital, the hospital contained more energy-intensive use rooms (ICUs) which resulted in higher operational and energy costs. XP-UV had a greater reduction in secondary COVID-19 infections in large and medium hospitals. NP rooms had a greater reduction in secondary SARS-CoV-2 transmission in small hospitals. Early implementation of interventions can result in realized cost savings through reduced hospital-acquired infections.
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Affiliation(s)
- Marietta M Squire
- Johns Hopkins University, Department of Civil and Systems Engineering, 3400 N. Charles St, Baltimore, MD 21218, USA
| | - Megashnee Munsamy
- Mangosuthu University of Technology, Mangosuthu Highway, Umlazi, Durban, South Africa
| | - Gary Lin
- Center for Disease Dynamics, Economics & Policy, Silver Spring, MD 20910, USA
| | | | - Takeru Igusa
- Johns Hopkins University, Department of Civil and Systems Engineering, 3400 N. Charles St, Baltimore, MD 21218, USA
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