Incentivizing hospital infection control

Incentivizing hospital infection control

Healthcare-associated infections (HAIs) pose a significant burden to patient safety. Institutions can implement hospital infection control (HIC) measures to reduce the impact of HAIs. Since patients can carry pathogens between institutions, there is an economic incentive for hospitals to free ride o...

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Bibliographic Details
Published in:Proceedings of the National Academy of Sciences - PNAS 2019-03, Vol.116 (13), p.6221-6225
Main Authors: Drohan, Sarah E., Levin, Simon A., Grenfell, Bryan T., Laxminarayan, Ramanan
Format: Article
Language:eng
Subjects:
Biological Sciences
Budgets
Cross Infection - economics
Cross Infection - epidemiology
Disease control
Drug Resistance, Microbial
Economic incentives
Economics, Hospital
Epidemiology
Game Theory
Health care
Hospital Costs
Hospitals
Humans
Infection Control
Infections
Mathematical models
Models, Theoretical
Patients
Prevalence
Public health
Regional development
Subsidies
Subsidies (financial)
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Summary:Healthcare-associated infections (HAIs) pose a significant burden to patient safety. Institutions can implement hospital infection control (HIC) measures to reduce the impact of HAIs. Since patients can carry pathogens between institutions, there is an economic incentive for hospitals to free ride on the HIC investments of other facilities. Subsidies for infection control by public health authorities could encourage regional spending on HIC. We develop coupled mathematical models of epidemiology and hospital behavior in a game-theoretic framework to investigate how hospitals may change spending behavior in response to subsidies. We demonstrate that under a limited budget, a dollar-for-dollar matching grant outperforms both a fixed-amount subsidy and a subsidy on uninfected patients in reducing the number of HAIs in a single institution. Additionally, when multiple hospitals serve a community, funding priority should go to the hospital with a lower transmission rate. Overall, subsidies incentivize HIC spending and reduce the overall prevalence of HAIs.
ISSN:0027-8424
1091-6490