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Costs and Savings Associated With Infection Control Measures That Reduced Transmission of Vancomycin-Resistant Enterococci in an Endemic Setting

Published online by Cambridge University Press:  02 January 2015

Marisa A. Montecalvo*
Affiliation:
Division of Infectious Diseases, New York Medical College, Valhalla, New York
William R. Jarvis
Affiliation:
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Jane Uman
Affiliation:
Graduate School of Health Sciences, New York Medical College, Valhalla, New York
David K. Shay
Affiliation:
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia
Coleen Petrullo
Affiliation:
Division of Infectious Diseases, New York Medical College, Valhalla, New York
Harold W. Horowitz
Affiliation:
Division of Infectious Diseases, New York Medical College, Valhalla, New York
Gary P. Wormser
Affiliation:
Division of Infectious Diseases, New York Medical College, Valhalla, New York
*
Division of Infectious Diseases, New York Medical College, Macy Pavilion 209SE, Valhalla, NY 10595

Abstract

Objective:

To determine the costs and savings of a 15-component infection control program that reduced transmission of vancomycin-resistant enterococci (VRE) in an endemic setting.

Design:

Evaluation of costs and savings, using historical control data.

Setting:

Adult oncology unit of a 650-bed hospital.

Participants:

Patients with leukemia, lymphoma, and solid tumors, excluding bone marrow transplant recipients.

Methods:

Costs and savings with estimated ranges were calculated. Excess length of stay (LOS) associated with VRE bloodstream infection (BSI) was determined by matching VRE BSI patients with VRE-negative patients by oncology diagnosis. Differences in LOS between the matched groups were evaluated using a mixed-effect analysis of variance linear-regression model.

Results:

The cost of enhanced infection control strategies for 1 year was $116,515. VRE BSI was associated with an increased LOS of 13.7 days. The savings associated with fewer VRE BSI ($123,081), fewer patients with VRE colonization ($2,755), and reductions in antimicrobial use ($179,997) totaled $305,833. Estimated ranges of costs and savings for enhanced infection control strategies were $97,939 to $148,883 for costs and $271,531 to $421,461 for savings.

Conclusion:

The net savings due to enhanced infection control strategies for 1 year was $189,318. Estimates suggest that these strategies would be cost-beneficial for hospital units where the number of patients with VRE BSI is at least see to nine patients per year or if the savings from fewer VRE BSI patients in combination with decreased antimicrobial use equalled $100,000 to $150,000 per year.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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