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The Cost of Responding to an Acinetobacter Outbreak in Critically Ill Surgical Patients.
Jiang, Yushan; Resch, Stephen; Liu, Xiaoxia; Rogers, Selwyn O; Askari, Reza; Klompas, Michael; Jayaraman, Sudha P.
Affiliation
  • Jiang Y; 1 Department of Health Policy and Management and Center for Health Decision Science, Harvard School of Public Health , Boston, Massachusetts.
  • Resch S; 1 Department of Health Policy and Management and Center for Health Decision Science, Harvard School of Public Health , Boston, Massachusetts.
  • Liu X; 2 Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital/Harvard Medical School , Boston, Massachusetts.
  • Rogers SO; 3 Department of Surgery, Temple University School of Medicine , Philadelphia, Pennsylvania.
  • Askari R; 2 Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital/Harvard Medical School , Boston, Massachusetts.
  • Klompas M; 4 Division of Infectious Disease, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, and Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute , Boston, Massachusetts.
  • Jayaraman SP; 5 Division of Acute Care Surgery, Department of Surgery, Virginia Commonwealth University , Richmond, Virginia.
Surg Infect (Larchmt) ; 17(1): 58-64, 2016 Feb.
Article in En | MEDLINE | ID: mdl-26356287
BACKGROUND: Our institution had an outbreak of multi-drug-resistant Acinetobacter (MDRA) in 2011. We analyzed the costs of responding to this outbreak from the hospital's perspective. METHODS: We estimated retrospectively the excess costs associated with an MDRA outbreak response at a major academic medical center, including the costs of staffing, supplies, administrative time, deep cleaning, and environmental testing. Differences in mean costs before and during the 2011 MDRA outbreak were analyzed using the Student t-test. RESULTS: The overall excess cost incurred during the outbreak response was $371,079 in 2011 U.S. dollars. The largest contributors were the extra resources needed to staff and clean the two intensive care units (ICUs) (78%). In the general surgery ICU, the mean weekly cost of nursing during the outbreak was $13,276 more for regular hours (+15%; p < 0.01) than in the pre-outbreak period and $2,682 more for overtime hours (+86%; p = 0.02). In the trauma ICU, the cost was $20,746 more for regular hours (+24%; p < 0.01) and $3,445 more for overtime hours (+124%; p < 0.01). The costs of supplies ($13,036; +30%; p = 0.03) and gloves ($2,572; +48%; p = 0.01) also were greater during the outbreak. Administrative time, consumables, use of a surge pod, and environmental testing accounted for the remainder of the extra costs. CONCLUSIONS: Our institution incurred $371,079 in excess costs as a result of an MDRA outbreak. This figure does not include the costs related to treatment of the infections, loss of reimbursement because of hospital-acquired infection, legal services, or changes in staff morale, patient satisfaction, or hospital reputation. Strategies to prevent and control such outbreaks better have substantial value.
Subject(s)

Full text: 1 Collection: 01-internacional Health context: 1_ASSA2030 / 2_ODS3 Database: MEDLINE Main subject: Acinetobacter Infections / Cross Infection / Disease Outbreaks / Infection Control Type of study: Health_economic_evaluation / Observational_studies / Risk_factors_studies Limits: Female / Humans / Male / Middle aged Language: En Journal: Surg Infect (Larchmt) Year: 2016 Document type: Article

Full text: 1 Collection: 01-internacional Health context: 1_ASSA2030 / 2_ODS3 Database: MEDLINE Main subject: Acinetobacter Infections / Cross Infection / Disease Outbreaks / Infection Control Type of study: Health_economic_evaluation / Observational_studies / Risk_factors_studies Limits: Female / Humans / Male / Middle aged Language: En Journal: Surg Infect (Larchmt) Year: 2016 Document type: Article