scholarly journals Pre-vaccination IgG screening for mumps is the most cost-effectiveness immunization strategy among Health Care Workers

2019 ◽  
Vol 15 (5) ◽  
pp. 1135-1138 ◽  
Author(s):  
Luca Coppeta ◽  
Ottavia Balbi ◽  
Savino Baldi ◽  
Antonio Pietroiusti ◽  
Andrea Magrini
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Workers ◽  
Immunization Strategy ◽  
Care Workers

scholarly journals Novel health system strategies for tuberculin skin test-guided Isoniazid preventive therapy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Van Ginderdeuren ◽  
J Bassett ◽  
C F Hanrahan ◽  
L Mutunga ◽  
A Van Rie
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Workers ◽  
Fast Track ◽  
Task Shifting ◽  
Preventive Therapy ◽  
Fast Tracking ◽  
Care Workers ◽  
Provider Perspective ◽  
Living With Hiv

Abstract Background Global TB elimination demands a scale-up of Isoniazid preventive therapy (IPT) but tuberculin skin test (TST)-guided IPT poses great logistical and human resource challenges. Objectives Performance of TST self-reading by patients and fast-track TST reading by trained low cadre health care workers (task-shifting) was compared to formal TST reading by high cadre staff in a cohort of 278 South African adults living with HIV. Health economic impact of these novel strategies was assessed from a provider and societal perspective and simulations were performed for 5 other countries (USA, Germany, Brazil, India, Russia) to evaluate generalizability. In addition, accuracy of TST at antiretroviral treatment (ART) initiation was assessed by a repeat TST 6 and 12 month later. Results TST self-reading was highly accurate, with 89% sensitivity (95% CI 80, 95) and 100% specificity (95% CI 97,100) for detecting presence/absence of any induration. Agreement in TST reading between low and high cadre health care workers was very high (kappa 0.97). Compared to standard of care, a combined fast-track, task-shifting and self-reading strategy reduced TST reading costs in South Africa from a patient perspective by 81% and from a provider perspective by 92%. In all 5 countries simulated, TST reading cost was reduced by ≥ 78 % from a provider perspective. Repeat testing at 6 and 12 months showed high (31%, 95% CI 23, 40) TST conversion during the first 12 months of ART. Conclusions Empiric IPT for all people living with HIV followed by TST assessment after 6 or 12 months to identify those in need for lifelong IPT could increase the effectiveness of IPT programs. TST self-reading to reduce the number of patients that need to return for TST reading (to only those patients with self-determined presence of any induration) together with fast-tracking and task-shifting of TST reading could increase cost-effectiveness and reduce patient costs associated with IPT programs. Key messages Novel strategies are essential to control TB. Task-shifting, fast-tracking and patient TST self-reading empower patients and HCWs; optimal TST timing can increase cost-effectiveness of IPT programs.

scholarly journals Cost-effectiveness and return on investment of protecting health workers in low- and middle-income countries during the COVID-19 pandemic

2020 ◽  
Author(s):  
Nicholas Risko ◽  
Kalin Werner ◽  
O. Agatha Offorjebe ◽  
Andres I. Vecino-Ortiz ◽  
Lee A. Wallis ◽  
...  
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Workers ◽  
Return On Investment ◽  
World Health ◽  
Decision Analytic Model ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Workers ◽  
Low And Middle Income

AbstractBackgroundIn this paper, we predict the health and economic consequences of immediate investment in personal protective equipment (PPE) for health care workers (HCWs) in low- and middle-income countries (LMICs).MethodsTo account for health consequences, we estimated mortality for health care workers (HCW), and present a cost-effectiveness and return on investment (ROI) analysis using a decision-analytic model with Bayesian multivariate sensitivity analysis and Monte Carlo simulation. Inputs were used from the World Health Organization Essential Supplies Forecasting Tool and the Imperial College of London epidemiologic model.ResultsAn investment of $9.6 billion USD would adequately protect HCWs in all LMICs. This intervention saves 2,299,543 lives across LMICs, costing $59 USD per HCW case averted and $4,309 USD per HCW life saved. The societal ROI is $755.3 billion USD, the equivalent of a 7,932% return. Regional and national estimates are also presented. In scenarios where PPE remains scarce, 70-100% of HCWs will get infected, irrespective of nationwide social distancing policies. Maintaining HCW infection rates below 10% and mortality below 1% requires inclusion of a PPE scale-up strategy as part of the pandemic response.DiscussionIn conclusion, wide-scale procurement and distribution of PPE for LMICs is an essential strategy to prevent widespread HCW morbidity and mortality. It is cost-effective and yields a large downstream return on investment.

scholarly journals Cost-effectiveness of seasonal influenza vaccination in pregnant women, health care workers and persons with underlying illnesses in Belgium

Vaccine ◽  
2014 ◽  
Vol 32 (46) ◽  
pp. 6075-6083 ◽  
Author(s):  
Adriaan Blommaert ◽  
Joke Bilcke ◽  
Yannick Vandendijck ◽  
Germaine Hanquet ◽  
Niel Hens ◽  
...  
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Influenza Vaccination ◽  
Pregnant Women ◽  
Health Care Workers ◽  
Seasonal Influenza ◽  
Seasonal Influenza Vaccination ◽  
Women Health ◽  
Care Workers

Cost-effectiveness of Tuberculosis Screening in Health Care Workers Is Not Robust—Reply

2009 ◽  
Vol 169 (14) ◽  
pp. 1336
Author(s):  
Marie A. de Perio ◽  
Joel Tsevat ◽  
Gary A. Roselle ◽  
Stephen M. Kralovic ◽  
Mark H. Eckman
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Workers ◽  
Tuberculosis Screening ◽  
Care Workers

Screening and Vaccination Against Measles and Varicella Among Health Care Workers: A Cost-effectiveness Analysis

2021 ◽  
pp. 101053952110264
Author(s):  
Ji-Suk Lee ◽  
Oh Jeong ◽  
Hyunju Yang
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Workers ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Health Care Facilities ◽  
Effective Strategy ◽  
Cost Effective Strategy ◽  
Effectiveness Analysis ◽  
Care Workers

The aim of this study was to examine the most cost-effective strategy of screening and vaccinating measles- and varicella-susceptible health care workers (HCWs). A retrospective cost-effectiveness analysis was conducted at a tertiary hospital in Korea with 300 HCWs who were at high risk of infection. Self-reported histories of vaccinations, infectious diseases, and contact with such cases were collected. Serological tests for immunoglobulin G titers of measles and varicella were performed. Data were analyzed using analysis of variance, Kruskal-Wallis test, χ2 test, and Fisher exact test. Seropositivity rates were 96.3% for measles and 95.7% for varicella. Four different strategies (cases) for vaccination were investigated. Considering the progressive decline in antibody concentrations and the false-positive responses in self-reported histories, case 3, which involved administering 2-dose vaccinations to susceptible HCWs demonstrated by antibody screening tests for both measles and varicella, was the most cost-effective strategy. Health care facilities should establish mandatory immunization policies that reduce the risk of transmission of vaccine-preventable diseases.

scholarly journals Optimal strategies to screen health care workers for COVID-19 in the US: a cost-effectiveness analysis

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Sigal Maya ◽  
Guntas Padda ◽  
Victoria Close ◽  
Trevor Wilson ◽  
Fareeda Ahmed ◽  
...  
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Workers ◽  
Cost Effective ◽  
Health Care Settings ◽  
Testing Strategies ◽  
Effectiveness Analysis ◽  
Care Workers ◽  
Antigen Testing ◽  
Quality Adjusted Life

Abstract Background Transmission of SARS-CoV-2 in health care facilities poses a challenge against pandemic control. Health care workers (HCWs) have frequent and high-risk interactions with COVID-19 patients. We undertook a cost-effectiveness analysis to determine optimal testing strategies for screening HCWs to inform strategic decision-making in health care settings. Methods We modeled the number of new infections, quality-adjusted life years lost, and net costs related to six testing strategies including no test. We applied our model to four strata of HCWs, defined by the presence and timing of symptoms. We conducted sensitivity analyses to account for uncertainty in inputs. Results When screening recently symptomatic HCWs, conducting only a PCR test is preferable; it saves costs and improves health outcomes in the first week post-symptom onset, and costs $83,000 per quality-adjusted life year gained in the second week post-symptom onset. When screening HCWs in the late clinical disease stage, none of the testing approaches is cost-effective and thus no testing is preferable, yielding $11 and 0.003 new infections per 10 HCWs. For screening asymptomatic HCWs, antigen testing is preferable to PCR testing due to its lower cost. Conclusions Both PCR and antigen testing are beneficial strategies to identify infected HCWs and reduce transmission of SARS-CoV-2 in health care settings. IgG tests’ value depends on test timing and immunity characteristics, however it is not cost-effective in a low prevalence setting. As the context of the pandemic evolves, our study provides insight to health-care decision makers to keep the health care workforce safe and transmissions low.

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