Cost-effectiveness of a national initiative to improve hand hygiene compliance using the outcome of healthcare associated Staphylococcus aureus bacteraemia

Graves, Nicholas, Page, Katie, Martin, Elizabeth, Brain, David, Hall, Lisa, Campbell, Megan, Fulop, Naomi, Jimmeison, Nerina, White, Katherine, Paterson, David and Barnett, Adrian G. (2016) Cost-effectiveness of a national initiative to improve hand hygiene compliance using the outcome of healthcare associated Staphylococcus aureus bacteraemia. PLoS One, 11 2: 1-17. doi:10.1371/journal.pone.0148190


Author Graves, Nicholas
Page, Katie
Martin, Elizabeth
Brain, David
Hall, Lisa
Campbell, Megan
Fulop, Naomi
Jimmeison, Nerina
White, Katherine
Paterson, David
Barnett, Adrian G.
Title Cost-effectiveness of a national initiative to improve hand hygiene compliance using the outcome of healthcare associated Staphylococcus aureus bacteraemia
Journal name PLoS One   Check publisher's open access policy
ISSN 1932-6203
Publication date 2016-02-09
Year available 2016
Sub-type Article (original research)
DOI 10.1371/journal.pone.0148190
Open Access Status DOI
Volume 11
Issue 2
Start page 1
End page 17
Total pages 17
Place of publication San Francisco, CA United States
Publisher Public Library of Science
Collection year 2017
Language eng
Formatted abstract
Background

The objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included.

Methods

The design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011–2012.

Findings

No useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by $2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER) of $29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of $1,030 and $8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of $33,353, a 26% chance for South Australia with an ICER of $64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of $1.51M; no information was available to describe cost savings or health benefits.

Conclusions

The Australian National Hand Hygiene Initiative was cost-effective against an Australian threshold of $42,000 per life year gained. The return on investment varied among the states and territories of Australia.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
HERDC Pre-Audit
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 1 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 1 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Sun, 06 Mar 2016, 00:26:35 EST by System User on behalf of UQ Centre for Clinical Research