Economic value of norovirus outbreak control measures in healthcare settings

Although norovirus is a significant cause of nosocomial viral gastroenteritis, the economic value of hospital outbreak containment measures following identification of a norovirus case is currently unknown. We developed computer simulation models to determine the potential cost-savings from the hosp...

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Bibliographic Details
Published in:Clinical microbiology and infection 2011-04, Vol.17 (4), p.640-646
Main Authors: Lee, B.Y., Wettstein, Z.S., McGlone, S.M., Bailey, R.R., Umscheid, C.A., Smith, K.J., Muder, R.R.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Caliciviridae Infections - economics
Caliciviridae Infections - prevention & control
Caliciviridae Infections - virology
Computer Simulation
Cost control
Cross Infection - economics
Cross Infection - prevention & control
Cross Infection - virology
Disease Outbreaks
Disease transmission
Disinfection
Economics
Gastroenteritis
Gastroenteritis - economics
Gastroenteritis - prevention & control
Gastroenteritis - virology
Hand
Health Care Costs - statistics & numerical data
Health Facilities
hospital
Hospitals
Humans
Hygiene
infection control
Infection Control - economics
Infection Control - methods
Infectious diseases
interventions
Mathematical models
Medical sciences
Norovirus
Norovirus - isolation & purification
outbreak
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Summary:Although norovirus is a significant cause of nosocomial viral gastroenteritis, the economic value of hospital outbreak containment measures following identification of a norovirus case is currently unknown. We developed computer simulation models to determine the potential cost-savings from the hospital perspective of implementing the following norovirus outbreak control interventions: (i) increased hand hygiene measures, (ii) enhanced disinfection practices, (iii) patient isolation, (iv) use of protective apparel, (v) staff exclusion policies, and (vi) ward closure. Sensitivity analyses explored the impact of varying intervention efficacy, number of initial norovirus cases, the norovirus reproductive rate (R0), and room, ward size, and occupancy. Implementing increased hand hygiene, using protective apparel, staff exclusion policies or increased disinfection separately or in bundles provided net cost-savings, even when the intervention was only 10% effective in preventing further norovirus transmission. Patient isolation or ward closure was cost-saving only when transmission prevention efficacy was very high (≥90%), and their economic value decreased as the number of beds per room and the number of empty beds per ward increased. Increased hand hygiene, using protective apparel or increased disinfection practices separately or in bundles are the most cost-saving interventions for the control and containment of a norovirus outbreak.
ISSN:1198-743X
1469-0691
DOI:10.1111/j.1469-0691.2010.03345.x