Bartenschlager Christina C, Temizel Selin, Ebigbo Alanna, Gruenherz Vivian, Gastmeier Petra, Messmann Helmut, Brunner Jens O, Römmele Christoph
Health Care Operations/Health Information Management, Faculty of Business and Economics, University of Augsburg, Augsburg, Germany; Faculty of Medicine, University of Augsburg, Augsburg, Germany.
Department of Hygiene and Environmental Medicine, University Hospital Augsburg, Augsburg, Germany.
Value Health. 2022 Nov;25(11):1846-1852. doi: 10.1016/j.jval.2022.04.1736. Epub 2022 Jun 2.
The aim is to quantitatively evaluate different infection prevention strategies in the context of hospital visitor management during pandemics and to provide a decision support system for strategic and operational decisions based on this evaluation.
A simulation-based cost-effectiveness analysis is applied to the data of a university hospital in Southern Germany and published COVID-19 research. The performance of different hospital visitor management strategies is evaluated by several decision-theoretic methods with varying objective functions.
Appropriate visitor restrictions and infection prevention measures can reduce additional infections and costs caused by visitors of healthcare institutions by >90%. The risk of transmission of severe acute respiratory syndrome coronavirus 2 by visitors of terminal care (ie, palliative care) patients can be reduced almost to 0 if appropriate infection prevention measures are implemented. Antigen tests do not seem to be beneficial from both a cost and an effectiveness perspective.
Hospital visitor management is crucial and effectively prevents infections while maintaining cost-effectiveness. For terminal care patients, visitor restrictions can be omitted if appropriate infection prevention measures are taken. Antigen testing plays a subordinate role, except in the case of a pure focus on additional infections caused by visitors of healthcare institutions. We provide decision support to authorities and hospital visitor managers to identify appropriate visitor restriction and infection prevention strategies for specific local conditions, incidence rates, and objectives.
旨在定量评估大流行期间医院访客管理背景下的不同感染预防策略，并基于该评估为战略和运营决策提供决策支持系统。
将基于模拟的成本效益分析应用于德国南部一家大学医院的数据以及已发表的关于2019冠状病毒病的研究。采用几种具有不同目标函数的决策理论方法评估不同医院访客管理策略的性能。
适当的访客限制和感染预防措施可将医疗机构访客导致的额外感染和成本降低90%以上。如果实施适当的感染预防措施，终末期护理（即姑息治疗）患者的访客传播严重急性呼吸综合征冠状病毒2的风险几乎可降至0。从成本和有效性角度来看，抗原检测似乎并无益处。
医院访客管理至关重要，既能有效预防感染，又能保持成本效益。对于终末期护理患者，如果采取适当的感染预防措施，可以省略访客限制。抗原检测起次要作用，除非单纯关注医疗机构访客导致的额外感染情况。我们为当局和医院访客管理人员提供决策支持，以确定针对特定当地情况、发病率和目标的适当访客限制和感染预防策略。
