A decade of investment in infection prevention: A cost-effectiveness analysis

Andrew W Dick; Eli N Perencevich; Monika Pogorzelska-Maziarz; Jack Zwanziger; Elaine L Larson; Patricia W Stone

doi:10.1016/j.ajic.2014.07.014

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A decade of investment in infection prevention: A cost-effectiveness analysis

Journal article

Peer reviewed

A decade of investment in infection prevention: A cost-effectiveness analysis

Andrew W Dick, Eli N Perencevich, Monika Pogorzelska-Maziarz, Jack Zwanziger, Elaine L Larson and Patricia W Stone

AJIC: American Journal of Infection Control, Vol.43(1), pp.4-9

01/01/2015

DOI: 10.1016/j.ajic.2014.07.014

PMCID: PMC4743241

PMID: 25564117

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Abstract

Health care–associated infection (HAI) rates have fallen with the development of multifaceted infection prevention programs. These programs require ongoing investments, however. Our objective was to examine the cost-effectiveness of hospitals' ongoing investments in HAI prevention in intensive care units (ICUs). Five years of Medicare data were combined with HAI rates and cost and quality of life estimates drawn from the literature. Life-years (LYs), quality-adjusted LYs (QALYs), and health care expenditures with and without central line–associated bloodstream infection (CLABSI) and/or ventilator-associated pneumonia (VAP), as well as incremental cost-effectiveness ratios (ICERs) of multifaceted HAI prevention programs, were modeled. Total LYs and QALYs gained per ICU due to infection prevention programs were 15.55 LY and 9.61 QALY for CLABSI and 10.84 LY and 6.55 QALY for VAP. Reductions in index admission ICU costs were $174,713.09 for CLABSI and $163,090.54 for VAP. The ICERs were $14,250.74 per LY gained and $23,277.86 per QALY gained. Multifaceted HAI prevention programs are cost-effective. Our results underscore the importance of maintaining ongoing investments in HAI prevention. The welfare benefits implied by the advantageous ICERs would be lost if the investments were suspended.

Ventilator-associated pneumonia

Cost analysis

Long-term costs

Economic evaluation

Central line–associated bloodstream infections

Quality of life

Details

Title: Subtitle: A decade of investment in infection prevention: A cost-effectiveness analysis
Creators: Andrew W Dick - RAND Corporation, Pittsburgh, PA
Eli N Perencevich - Divisions of General Internal Medicine and Infectious Diseases, Department of Internal Medicine University of Iowa, Carver College of Medicine and Iowa City VA Medical Center, Iowa City, IA
Monika Pogorzelska-Maziarz - Jefferson School of Nursing, Thomas Jefferson University, Philadelphia, PA
Jack Zwanziger - Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL
Elaine L Larson - Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
Patricia W Stone - Center for Health Policy, School of Nursing, Columbia University, New York, NY
Resource Type: Journal article
Publication Details: AJIC: American Journal of Infection Control, Vol.43(1), pp.4-9
DOI: 10.1016/j.ajic.2014.07.014
PMID: 25564117
PMCID: PMC4743241
NLM abbreviation: Am J Infect Control
ISSN: 0196-6553
eISSN: 1527-3296
Publisher: Elsevier Inc
Grant note: R01NR010107 / National Institute of Nursing Research (http://dx.doi.org/10.13039/100000056)
Language: English
Date published: 01/01/2015
Academic Unit: Epidemiology; Internal Medicine
Record Identifier: 9983779293602771

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