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

Eric Nguemeleu Tchouaket (), Fatima El-Mousawi, Stephanie Robins, Katya Kruglova, Catherine Séguin, Kelley Kilpatrick, Maripier Jubinville, Suzanne Leroux, Idrissa Beogo and Drissa Sia
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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

Health Economics Review, 2024, vol. 14, issue 1, 1-18

Abstract: 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.

Date: 2024
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DOI: 10.1186/s13561-024-00582-8

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