Health Services & Systems Research, Duke-NUS Medical School, Singapore.
School of Nursing and Midwifery, University of Newcastle, Ourimbah, NSW, Australia.
J Hosp Infect. 2021 Oct;116:21-28. doi: 10.1016/j.jhin.2021.07.003. Epub 2021 Jul 8.
The use of single rooms for patient isolation often forms part of a wider bundle to prevent certain healthcare-associated infections (HAIs) in hospitals. Demand for single rooms often exceeds what is available and the use of temporary isolation rooms may help resolve this. Changes to infection prevention practice should be supported by evidence showing that cost-effectiveness is plausible and likely.
To perform a cost-effectiveness evaluation of adopting temporary single rooms into UK National Health Service (NHS) hospitals.
The cost-effectiveness of a decision to adopt a temporary, single-patient, isolation room to the current infection prevention efforts of an NHS hospital was modelled. Primary outcomes are the expected change to total costs and life-years from an NHS perspective.
The mean expected incremental cost per life-year gained (LYG) is £5,829. The probability that adoption is cost-effective against a £20,000 threshold per additional LYG is 93%, and for a £13,000 threshold the probability is 87%. The conclusions are robust to scenarios for key model parameters. If a temporary single-patient isolation room reduces risks of HAI by 16.5% then an adoption decision is more likely to be cost-effective than not. Our estimate of the effectiveness reflects guidelines and reasonable assumptions and the theoretical rationale is strong.
Despite uncertainties about the effectiveness of temporary isolation rooms for reducing risks of HAI, there is some evidence that an adoption decision is likely to be cost-effective for the NHS setting. Prospective studies will be useful to reduce this source of uncertainty.
单间病房的使用通常是防止医院内某些医疗相关感染（HAI）的综合措施的一部分。单间病房的需求往往超过了现有数量，因此临时隔离病房的使用可能有助于解决这一问题。感染预防措施的改变应得到证据的支持，表明成本效益是合理且可能的。
对英国国民保健制度（NHS）医院采用临时单间病房进行成本效益评估。
对 NHS 医院当前感染预防措施采用临时单间隔离病房的决策进行成本效益建模。主要结果是从 NHS 角度预期的总成本和生命年的变化。
预期每获得一个生命年的增量成本的平均值为 5829 英镑。采用该方法的增量成本-效果比（ICER）为每额外增加一个生命年 20000 英镑的概率为 93%，13000 英镑的概率为 87%。结论对关键模型参数的情景具有稳健性。如果临时单间隔离病房能将 HAI 风险降低 16.5%，则采用该方法的决策更有可能具有成本效益。我们对疗效的估计反映了指南和合理假设，理论基础是强有力的。
尽管临时隔离病房在降低 HAI 风险方面的有效性存在不确定性，但有证据表明，这一决策在 NHS 环境中可能具有成本效益。前瞻性研究将有助于减少这一不确定性来源。
