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A Cost-Benefit Analysis of Gown Use in Controlling Vancomycin-Resistant Enterococcus Transmission Is It Worth the Price?

Published online by Cambridge University Press:  02 January 2015

Laura A. Puzniak ,
Kathleen N. Gillespie ,
Terry Leet ,
Marin Kollef  and
Linda M. Mundy
Laura A. Puzniak
Affiliation:
Department of Community Health, St. Louis, Missouri
Kathleen N. Gillespie
Affiliation:
Department of Health Management and Policy, Saint Louis University School of Public Health, St. Louis, Missouri
Terry Leet
Affiliation:
Department of Community Health, St. Louis, Missouri
Marin Kollef
Affiliation:
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
Linda M. Mundy*
Affiliation:
Department of Community Health, St. Louis, Missouri Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
*
Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8051, St. Louis, MO 63110
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Abstract

Objective:

To determine the net benefit and costs associated with gown use in preventing transmission of van-comycin-resistant Enterococcus (VRE).

Design:

A cost-benefit analysis measuring the net benefit of gowns was performed. Benefits, defined as averted costs from reduced VRE colonization and infection, were estimated using a matched cohort study. Data sources included a step-down cost allocation system, hospital informatics, and microbiology databases.

Setting:

The medical intensive care unit (MICU) at Barnes-Jewish Hospital, St. Louis, Missouri.

Patients:

Patients admitted to the MICU for more than 24 hours from July 1, 1997, to December 31, 1999.

Interventions:

Alternating periods when all healthcare workers and visitors were required to wear gowns and gloves versus gloves alone on entry to the rooms of patients colonized or infected with VRE.

Results:

On base-case analysis, 58 VRE cases were averted with gown use during 18 months. The annual net benefit of the gown policy was $419,346 and the cost per case averted of VRE was $1,897. The analysis was most sensitive to the level of VRE transmission.

Conclusions:

Infection control policies (eg, gown use) initially increase the cost of health services delivery. However, such policies can be cost saving by averting nosocomial infections and the associated costs of treatment. The cost savings to the hospital plus the benefits to patients and their families of avoiding nosocomial infections make effective infection control policies a good investment.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 5 , May 2004 , pp. 418 - 424
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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