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

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  • Eric Nguemeleu Tchouaket

    (Université du Québec en Outaouais)

  • Fatima El-Mousawi

    (Université du Québec en Outaouais)

  • Stephanie Robins

    (Université du Québec en Outaouais)

  • Katya Kruglova

    (Université du Québec en Outaouais)

  • Catherine Séguin

    (Université du Québec en Outaouais)

  • Kelley Kilpatrick

    (McGill University)

  • Maripier Jubinville

    (Université du Québec en Outaouais)

  • Suzanne Leroux

    (Université du Québec en Outaouais)

  • Idrissa Beogo

    (University of Ottawa)

  • Drissa Sia

    (Université du Québec en Outaouais)

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.

Suggested Citation

  • Eric Nguemeleu Tchouaket & Fatima El-Mousawi & Stephanie Robins & Katya Kruglova & Catherine Séguin & Kelley Kilpatrick & Maripier Jubinville & Suzanne Leroux & Idrissa Beogo & Drissa Sia, 2024. "A systematic review of economic evaluation of healthcare associated infection prevention and control interventions in long term care facilities," Health Economics Review, Springer, vol. 14(1), pages 1-18, December.
    • Handle: RePEc:spr:hecrev:v:14:y:2024:i:1:d:10.1186_s13561-024-00582-8
    DOI: 10.1186/s13561-024-00582-8
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
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