The potential economic value of screening hospital admissions for Clostridium difficile.
Eur J Clin Microbiol Infect Dis
; 31(11): 3163-71, 2012 Nov.
Article
de En
| MEDLINE
| ID: mdl-22752150
ABSTRACT
Asymptomatic Clostridium difficile carriage has a prevalence reported as high as 51-85 %; with up to 84 % of incident hospital-acquired infections linked to carriers. Accurately identifying carriers may limit the spread of Clostridium difficile. Since new technology adoption depends heavily on its economic value, we developed an analytic simulation model to determine the cost-effectiveness screening hospital admissions for Clostridium difficile from the hospital and third party payer perspectives. Isolation precautions were applied to patients testing positive, preventing transmission. Sensitivity analyses varied Clostridium difficile colonization rate, infection probability among secondary cases, contact isolation compliance, and screening cost. Screening was cost-effective (i.e., incremental cost-effectiveness ratio [ICER] ≤ $50,000/QALY) for every scenario tested; all ICER values were ≤ $256/QALY. Screening was economically dominant (i.e., saved costs and provided health benefits) with a ≥10.3 % colonization rate and ≥5.88 % infection probability when contact isolation compliance was ≥25 % (hospital perspective). Under some conditions screening led to cost savings per case averted (range, $53-272). Clostridium difficile screening, coupled with isolation precautions, may be a cost-effective intervention to hospitals and third party payers, based on prevalence. Limiting Clostridium difficile transmission can reduce the number of infections, thereby reducing its economic burden to the healthcare system.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
État de porteur sain
/
Dépistage de masse
/
Clostridioides difficile
/
Infections à Clostridium
/
Tests diagnostiques courants
Type d'étude:
Diagnostic_studies
/
Health_economic_evaluation
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limites:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Langue:
En
Journal:
Eur J Clin Microbiol Infect Dis
Sujet du journal:
DOENCAS TRANSMISSIVEIS
/
MICROBIOLOGIA
Année:
2012
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique