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Economic evaluation of interventions designed to reduce Clostridium difficile infection

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  • David Brain
  • Laith Yakob
  • Adrian Barnett
  • Thomas Riley
  • Archie Clements
  • Kate Halton
  • Nicholas Graves

Abstract

Introduction: Healthcare decision-makers are increasingly expected to balance increasing demand for health services with a finite budget. The role of economic evaluation in healthcare is increasing and this research provides decision-makers with new information about the management of Clostridium difficile infection, from an economic perspective. Methods: A model-based economic evaluation was undertaken to identify the most cost-effective healthcare intervention relating to the reduction of Clostridium difficile transmission. Efficacy evidence was synthesised from the literature and was used to inform the effectiveness of both bundled approaches and stand-alone interventions, where appropriate intervention combinations were coupled together. Changes in health outcomes were estimated by combining information about intervention effectiveness and its subsequent impact on quality of life. Results: A bundled approach of improving hand hygiene and environmental cleaning produces the best combination of increased health benefits and cost-savings. It has the highest mean net monetary benefit when compared to all other interventions. This intervention remains the optimal decision under different clinical circumstances, such as when mortality rate and patient length of stay are increased. Bundled interventions offered the best opportunity for health improvements. Conclusion: These findings provide healthcare decision-makers with novel information about the allocation of scarce resources relating to Clostridium difficile. If investments are not made in interventions that clearly yield gains in health outcomes, the allocation and use of scarce healthcare resources is inappropriate and improvements in health outcomes will be forgone.

Suggested Citation

  • David Brain & Laith Yakob & Adrian Barnett & Thomas Riley & Archie Clements & Kate Halton & Nicholas Graves, 2018. "Economic evaluation of interventions designed to reduce Clostridium difficile infection," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-15, January.
    • Handle: RePEc:plo:pone00:0190093
    DOI: 10.1371/journal.pone.0190093
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    References listed on IDEAS

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    1. Aaron A. Stinnett & John Mullahy, 1998. "Net Health Benefits," Medical Decision Making, , vol. 18(2_suppl), pages 68-80, April.
    2. Hugh Gravelle & Werner Brouwer & Louis Niessen & Maarten Postma & Frans Rutten, 2007. "Discounting in economic evaluations: stepping forward towards optimal decision rules," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 307-317, March.
    3. Lauren Lapointe-Shaw & Kim L Tran & Peter C Coyte & Rebecca L Hancock-Howard & Jeff Powis & Susan M Poutanen & Susy Hota, 2016. "Cost-Effectiveness Analysis of Six Strategies to Treat Recurrent Clostridium difficile Infection," PLOS ONE, Public Library of Science, vol. 11(2), pages 1-18, February.
    4. Aaron A. Stinnett & John Mullahy, 1998. "Net Health Benefits: A New Framework for the Analysis of Uncertainty in Cost-Effectiveness Analysis," NBER Technical Working Papers 0227, National Bureau of Economic Research, Inc.
    5. Richard E Nelson & Makoto Jones & Molly Leecaster & Matthew H Samore & William Ray & Angela Huttner & Benedikt Huttner & Karim Khader & Vanessa W Stevens & Dale Gerding & Marin L Schweizer & Michael A, 2016. "An Economic Analysis of Strategies to Control Clostridium Difficile Transmission and Infection Using an Agent-Based Simulation Model," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-16, March.
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