Cost-effectiveness Analysis of Hospital Infection Control Response to an Epidemic Respiratory Virus Threat
Identifieur interne : 000D36 ( Pmc/Checkpoint ); précédent : 000D35; suivant : 000D37Cost-effectiveness Analysis of Hospital Infection Control Response to an Epidemic Respiratory Virus Threat
Auteurs : Yock Young Dan ; Paul A. Tambyah ; Joe Sim ; Jeremy Lim ; Li Yang Hsu ; Wai Leng Chow ; Dale A. Fisher ; Yue Sie Wong ; Khek Yu HoSource :
- Emerging Infectious Diseases [ 1080-6040 ] ; 2009.
Abstract
Pandemic (H1N1) 2009 can be contained with less expensive measures than some other viruses.
Url:
DOI: 10.3201/eid1512.090902
PubMed: 19961669
PubMed Central: 3044543
Affiliations:
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PMC:3044543Le document en format XML
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<author><name sortKey="Dan, Yock Young" sort="Dan, Yock Young" uniqKey="Dan Y" first="Yock Young" last="Dan">Yock Young Dan</name>
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<author><name sortKey="Tambyah, Paul A" sort="Tambyah, Paul A" uniqKey="Tambyah P" first="Paul A." last="Tambyah">Paul A. Tambyah</name>
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<author><name sortKey="Sim, Joe" sort="Sim, Joe" uniqKey="Sim J" first="Joe" last="Sim">Joe Sim</name>
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<author><name sortKey="Lim, Jeremy" sort="Lim, Jeremy" uniqKey="Lim J" first="Jeremy" last="Lim">Jeremy Lim</name>
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<author><name sortKey="Hsu, Li Yang" sort="Hsu, Li Yang" uniqKey="Hsu L" first="Li Yang" last="Hsu">Li Yang Hsu</name>
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<author><name sortKey="Chow, Wai Leng" sort="Chow, Wai Leng" uniqKey="Chow W" first="Wai Leng" last="Chow">Wai Leng Chow</name>
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<author><name sortKey="Fisher, Dale A" sort="Fisher, Dale A" uniqKey="Fisher D" first="Dale A." last="Fisher">Dale A. Fisher</name>
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<author><name sortKey="Wong, Yue Sie" sort="Wong, Yue Sie" uniqKey="Wong Y" first="Yue Sie" last="Wong">Yue Sie Wong</name>
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<author><name sortKey="Ho, Khek Yu" sort="Ho, Khek Yu" uniqKey="Ho K" first="Khek Yu" last="Ho">Khek Yu Ho</name>
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<author><name sortKey="Tambyah, Paul A" sort="Tambyah, Paul A" uniqKey="Tambyah P" first="Paul A." last="Tambyah">Paul A. Tambyah</name>
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<author><name sortKey="Sim, Joe" sort="Sim, Joe" uniqKey="Sim J" first="Joe" last="Sim">Joe Sim</name>
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<author><name sortKey="Lim, Jeremy" sort="Lim, Jeremy" uniqKey="Lim J" first="Jeremy" last="Lim">Jeremy Lim</name>
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<author><name sortKey="Hsu, Li Yang" sort="Hsu, Li Yang" uniqKey="Hsu L" first="Li Yang" last="Hsu">Li Yang Hsu</name>
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<author><name sortKey="Chow, Wai Leng" sort="Chow, Wai Leng" uniqKey="Chow W" first="Wai Leng" last="Chow">Wai Leng Chow</name>
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<author><name sortKey="Fisher, Dale A" sort="Fisher, Dale A" uniqKey="Fisher D" first="Dale A." last="Fisher">Dale A. Fisher</name>
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<author><name sortKey="Wong, Yue Sie" sort="Wong, Yue Sie" uniqKey="Wong Y" first="Yue Sie" last="Wong">Yue Sie Wong</name>
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<author><name sortKey="Ho, Khek Yu" sort="Ho, Khek Yu" uniqKey="Ho K" first="Khek Yu" last="Ho">Khek Yu Ho</name>
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<series><title level="j">Emerging Infectious Diseases</title>
<idno type="ISSN">1080-6040</idno>
<idno type="eISSN">1080-6059</idno>
<imprint><date when="2009">2009</date>
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<front><div type="abstract" xml:lang="en"><p>Pandemic (H1N1) 2009 can be contained with less expensive measures than some other viruses.</p>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Emerg Infect Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">Emerging Infect. Dis</journal-id>
<journal-id journal-id-type="publisher-id">EID</journal-id>
<journal-title-group><journal-title>Emerging Infectious Diseases</journal-title>
</journal-title-group>
<issn pub-type="ppub">1080-6040</issn>
<issn pub-type="epub">1080-6059</issn>
<publisher><publisher-name>Centers for Disease Control and Prevention</publisher-name>
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<article-meta><article-id pub-id-type="pmid">19961669</article-id>
<article-id pub-id-type="pmc">3044543</article-id>
<article-id pub-id-type="publisher-id">09-0902</article-id>
<article-id pub-id-type="doi">10.3201/eid1512.090902</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research</subject>
</subj-group>
</article-categories>
<title-group><article-title>Cost-effectiveness Analysis of Hospital Infection Control Response to an Epidemic Respiratory Virus Threat</article-title>
<alt-title alt-title-type="running-head">Infection Control and Epidemic Respiratory Virus</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Dan</surname>
<given-names>Yock Young</given-names>
</name>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Tambyah</surname>
<given-names>Paul A.</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Sim</surname>
<given-names>Joe</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Lim</surname>
<given-names>Jeremy</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Hsu</surname>
<given-names>Li Yang</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Chow</surname>
<given-names>Wai Leng</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Fisher</surname>
<given-names>Dale A.</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Wong</surname>
<given-names>Yue Sie</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Ho</surname>
<given-names>Khek Yu</given-names>
</name>
</contrib>
<aff id="aff1">National University Health System, Singapore (Y.Y. Dan, P.A. Tambyah, J. Sim, L.Y. Hsu, D.A. Fisher, K.Y. Ho)</aff>
<aff id="aff2">Singapore General Hospital, Singapore (J. Lim, W.L. Chow, Y.S. Wong)</aff>
</contrib-group>
<author-notes><corresp id="cor1">Address for correspondence: Paul A. Tambyah, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 5 Lower Kent Ridge Rd, NUH Level 3, Singapore 119074; email: <email xlink:href="mdcpat@nus.edu.sg">mdcpat@nus.edu.sg</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>12</month>
<year>2009</year>
</pub-date>
<volume>15</volume>
<issue>12</issue>
<fpage>1909</fpage>
<lpage>1916</lpage>
<abstract abstract-type="toc"><p>Pandemic (H1N1) 2009 can be contained with less expensive measures than some other viruses.</p>
</abstract>
<abstract><p>The outbreak of influenza A pandemic (H1N1) 2009 prompted many countries in Asia, previously strongly affected by severe acute respiratory syndrome (SARS), to respond with stringent measures, particularly in preventing outbreaks in hospitals. We studied actual direct costs and cost-effectiveness of different response measures from a hospital perspective in tertiary hospitals in Singapore by simulating outbreaks of SARS, pandemic (H1N1) 2009, and 1918 Spanish influenza. Protection measures targeting only infected patients yielded lowest incremental cost/death averted of $23,000 (US$) for pandemic (H1N1) 2009. Enforced protection in high-risk areas (Yellow Alert) and full protection throughout the hospital (Orange Alert) averted deaths but came at an incremental cost of up to $2.5 million/death averted. SARS and Spanish influenza favored more stringent measures. High case-fatality rates, virulence, and high proportion of atypical manifestations impacted cost-effectiveness the most. A calibrated approach in accordance with viral characteristics and community risks may help refine responses to future epidemics.</p>
</abstract>
<kwd-group kwd-group-type="author"><title>Keywords: </title>
<kwd>Pandemic (H1N1) 2009</kwd>
<kwd>pandemic</kwd>
<kwd>cost-effectiveness analysis</kwd>
<kwd>hospital infection control</kwd>
<kwd>nosocomial infections</kwd>
<kwd>influenza</kwd>
<kwd>viruses</kwd>
<kwd>expedited</kwd>
<kwd>research</kwd>
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</front>
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<tree><noCountry><name sortKey="Chow, Wai Leng" sort="Chow, Wai Leng" uniqKey="Chow W" first="Wai Leng" last="Chow">Wai Leng Chow</name>
<name sortKey="Dan, Yock Young" sort="Dan, Yock Young" uniqKey="Dan Y" first="Yock Young" last="Dan">Yock Young Dan</name>
<name sortKey="Fisher, Dale A" sort="Fisher, Dale A" uniqKey="Fisher D" first="Dale A." last="Fisher">Dale A. Fisher</name>
<name sortKey="Ho, Khek Yu" sort="Ho, Khek Yu" uniqKey="Ho K" first="Khek Yu" last="Ho">Khek Yu Ho</name>
<name sortKey="Hsu, Li Yang" sort="Hsu, Li Yang" uniqKey="Hsu L" first="Li Yang" last="Hsu">Li Yang Hsu</name>
<name sortKey="Lim, Jeremy" sort="Lim, Jeremy" uniqKey="Lim J" first="Jeremy" last="Lim">Jeremy Lim</name>
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<name sortKey="Wong, Yue Sie" sort="Wong, Yue Sie" uniqKey="Wong Y" first="Yue Sie" last="Wong">Yue Sie Wong</name>
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