Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore.
School of Nursing and Midwifery, University of Newcastle, Ourimbah, NSW, Australia.
PLoS One. 2022 Jul 22;17(7):e0271739. doi: 10.1371/journal.pone.0271739. eCollection 2022.
To estimate the change to health service costs and health benefits from a decision to adopt temporary isolation rooms that are effective at isolating the patient within a general ward environment. We assess the cost-effectiveness of a decision to adopt an existing temporary isolation room in a Singapore setting.
We performed a model-based cost-effectiveness analysis to evaluate the impact of a decision to adopt temporary isolation rooms for infection prevention. We estimated changes to the costs from implementation, the number of cases of healthcare associated infection, acute care bed days used, they money value of bed days, the number of deaths, and the expected change to life years. We report the probability that adoption was cost-effective by the cost by life year gained, against a relevant threshold. Uncertainty is addressed with probabilistic sensitivity analysis and the findings are tested with plausible scenarios for the effectiveness of the intervention.
We predict 478 fewer cases of HAI per 100,000 occupied bed days from a decision to adopt temporary isolation rooms. This will result in cost savings of $SGD329,432 and there are 1,754 life years gained. When the effectiveness of the intervention is set at 1% of cases of HAI prevented the incremental cost per life year saved is $16,519; below the threshold chosen for cost-effectiveness in Singapore.
We provide some evidence that adoption of a temporary isolation room is cost-effective for Singapore acute care hospitals. It is plausible that adoption is a positive decision for other countries in the region who may demonstrate fewer resources for infection prevention and control.
评估在普通病房环境中采用有效隔离患者的临时隔离病房对卫生服务成本和健康效益的改变。我们评估了在新加坡采用现有临时隔离病房的决策的成本效益。
我们进行了基于模型的成本效益分析，以评估采用临时隔离病房进行感染预防的决策的影响。我们估计了实施成本、医疗保健相关感染病例数、急性护理床位使用天数、床位天数的货币价值、死亡人数以及预期的生命年变化的变化。我们报告了采用成本效益的概率，采用成本与获得的生命年进行比较，并针对干预措施的有效性提出了合理的情景进行概率敏感性分析。
我们预测，采用临时隔离病房的决策将使每 100,000 个占用床位减少 478 例 HAI。这将节省 329,432 新元的成本，并获得 1,754 个生命年。当干预措施的有效性设定为预防 1%的 HAI 病例时，每节省一个生命年的增量成本为 16,519 新元；低于新加坡选择的成本效益阈值。
我们提供了一些证据表明，采用临时隔离病房对新加坡急性护理医院来说是具有成本效益的。对于该地区其他资源较少的国家来说，采用临时隔离病房可能是一个积极的决策。
