A systematic review of economic evaluation of healthcare associated infection prevention and control interventions in long term care facilities

Abstract Background Healthcare-associated infections (HCAI) are common in long-term care facilities (LTCF) and cause significant burden. Infection prevention and control (IPC) measures include the clinical best practices (CBP) of hand hygiene, hygiene and sanitation, screening, and basic and additio...

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Main Authors: Eric Nguemeleu Tchouaket, Fatima El-Mousawi, Stephanie Robins, Katya Kruglova, Catherine Séguin, Kelley Kilpatrick, Maripier Jubinville, Suzanne Leroux, Idrissa Beogo, Drissa Sia
Format: Article
Language:English
Published: BMC 2024-11-01
Series:Health Economics Review
Online Access:https://doi.org/10.1186/s13561-024-00582-8
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author Eric Nguemeleu Tchouaket
Fatima El-Mousawi
Stephanie Robins
Katya Kruglova
Catherine Séguin
Kelley Kilpatrick
Maripier Jubinville
Suzanne Leroux
Idrissa Beogo
Drissa Sia
author_facet Eric Nguemeleu Tchouaket
Fatima El-Mousawi
Stephanie Robins
Katya Kruglova
Catherine Séguin
Kelley Kilpatrick
Maripier Jubinville
Suzanne Leroux
Idrissa Beogo
Drissa Sia
author_sort Eric Nguemeleu Tchouaket
collection DOAJ
description Abstract Background Healthcare-associated infections (HCAI) are common in long-term care facilities (LTCF) and cause significant burden. Infection prevention and control (IPC) measures include the clinical best practices (CBP) of hand hygiene, hygiene and sanitation, screening, and basic and additional precautions. Few studies demonstrate their cost-effectiveness in LTCF, and those that do, largely focus on one CBP. An overarching synthesis of IPC economic analyses in this context is warranted. The aim of this paper is to conduct a systematic review of economic evaluations of CBP applied in LTCF. Methods We twice queried CINAHL, Cochrane, EconLit, Embase, Medline, Web of Science and Scopus for studies published in the last three decades of economic evaluations of CBP in LTCF. We included controlled and randomized clinical trials, cohort, longitudinal, follow-up, prospective, retrospective, cross-sectional, and simulations studies, as well as those based on mathematical or statistical modelling. Two reviewers conducted study selection, data extraction, and quality assessment of studies. We applied discounting rates of 3%, 5% and 8%, and presented all costs in 2022 Canadian dollars. The protocol of this review was registered with Research Registry (reviewregistry1210) and published in BMC Systematic Reviews. Findings We found 3,331 records and then 822 records; ten studies were retained. The economic analyses described were cost-minimization (n = 1), cost-benefit (n = 1), cost-savings (n = 2), cost-utility (n = 2) and cost-effectiveness which included cost-utility and cost-benefit analyses (n = 4). Four studies were high quality, three were moderate, and three were low quality. Inter-rater agreement for quality assessment was 91⋅7%. All studies (n = 10) demonstrated that CBP associated with IPC are clinically effective in LTCF and many (n = 6) demonstrated their cost effectiveness. Interpretation Ongoing economic evaluation research of IPC remains essential to underpin healthcare policy choices guided by empirical evidence for LTCF residents and staff.
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spelling doaj-art-5a202c257e974fd996c6f818322e4b8e2025-08-20T02:51:46ZengBMCHealth Economics Review2191-19912024-11-0114111810.1186/s13561-024-00582-8A systematic review of economic evaluation of healthcare associated infection prevention and control interventions in long term care facilitiesEric Nguemeleu Tchouaket0Fatima El-Mousawi1Stephanie Robins2Katya Kruglova3Catherine Séguin4Kelley Kilpatrick5Maripier Jubinville6Suzanne Leroux7Idrissa Beogo8Drissa Sia9Canadian Research Chair in the Economics of Infection Prevention and Control, Department of Nursing, Université du Québec en OutaouaisCanadian Research Chair in the Economics of Infection Prevention and Control, Department of Nursing, Université du Québec en OutaouaisCanadian Research Chair in the Economics of Infection Prevention and Control, Department of Nursing, Université du Québec en OutaouaisCanadian Research Chair in the Economics of Infection Prevention and Control, Department of Nursing, Université du Québec en OutaouaisCanadian Research Chair in the Economics of Infection Prevention and Control, Department of Nursing, Université du Québec en OutaouaisSusan E. French Chair in Nursing Research and Innovative Practice, Ingram School of Nursing, McGill UniversityCanadian Research Chair in the Economics of Infection Prevention and Control, Department of Nursing, Université du Québec en OutaouaisCanadian Research Chair in the Economics of Infection Prevention and Control, Department of Nursing, Université du Québec en OutaouaisSchool of Nursing, University of OttawaCanadian Research Chair in the Economics of Infection Prevention and Control, Department of Nursing, Université du Québec en OutaouaisAbstract Background Healthcare-associated infections (HCAI) are common in long-term care facilities (LTCF) and cause significant burden. Infection prevention and control (IPC) measures include the clinical best practices (CBP) of hand hygiene, hygiene and sanitation, screening, and basic and additional precautions. Few studies demonstrate their cost-effectiveness in LTCF, and those that do, largely focus on one CBP. An overarching synthesis of IPC economic analyses in this context is warranted. The aim of this paper is to conduct a systematic review of economic evaluations of CBP applied in LTCF. Methods We twice queried CINAHL, Cochrane, EconLit, Embase, Medline, Web of Science and Scopus for studies published in the last three decades of economic evaluations of CBP in LTCF. We included controlled and randomized clinical trials, cohort, longitudinal, follow-up, prospective, retrospective, cross-sectional, and simulations studies, as well as those based on mathematical or statistical modelling. Two reviewers conducted study selection, data extraction, and quality assessment of studies. We applied discounting rates of 3%, 5% and 8%, and presented all costs in 2022 Canadian dollars. The protocol of this review was registered with Research Registry (reviewregistry1210) and published in BMC Systematic Reviews. Findings We found 3,331 records and then 822 records; ten studies were retained. The economic analyses described were cost-minimization (n = 1), cost-benefit (n = 1), cost-savings (n = 2), cost-utility (n = 2) and cost-effectiveness which included cost-utility and cost-benefit analyses (n = 4). Four studies were high quality, three were moderate, and three were low quality. Inter-rater agreement for quality assessment was 91⋅7%. All studies (n = 10) demonstrated that CBP associated with IPC are clinically effective in LTCF and many (n = 6) demonstrated their cost effectiveness. Interpretation Ongoing economic evaluation research of IPC remains essential to underpin healthcare policy choices guided by empirical evidence for LTCF residents and staff.https://doi.org/10.1186/s13561-024-00582-8
spellingShingle Eric Nguemeleu Tchouaket
Fatima El-Mousawi
Stephanie Robins
Katya Kruglova
Catherine Séguin
Kelley Kilpatrick
Maripier Jubinville
Suzanne Leroux
Idrissa Beogo
Drissa Sia
A systematic review of economic evaluation of healthcare associated infection prevention and control interventions in long term care facilities
Health Economics Review
title A systematic review of economic evaluation of healthcare associated infection prevention and control interventions in long term care facilities
title_full A systematic review of economic evaluation of healthcare associated infection prevention and control interventions in long term care facilities
title_fullStr A systematic review of economic evaluation of healthcare associated infection prevention and control interventions in long term care facilities
title_full_unstemmed A systematic review of economic evaluation of healthcare associated infection prevention and control interventions in long term care facilities
title_short A systematic review of economic evaluation of healthcare associated infection prevention and control interventions in long term care facilities
title_sort systematic review of economic evaluation of healthcare associated infection prevention and control interventions in long term care facilities
url https://doi.org/10.1186/s13561-024-00582-8
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