A Systematic Review of Economic Evaluations of Healthcare Associated Infection Prevention and Control Interventions in Long Term Care Facilities
Author(s)
Eric Tchouaket, PhD1, Fatima El-Mousawi, MSc.1, Stephanie Robins, MSc.1, Katya Kruglova, MSc.1, Catherine Seguin, MSc.2, Kelley Kilpatrick, PhD3, Maripier Jubinville, PhD1, Suzanne Leroux, BSc., DESS1, Idrissa Beogo, MBA, PhD4, Drissa Sia, MD1;
1Université du Québec en Outaouais, Nursing, St.Jérôme, QC, Canada, 2Université du Québec en Outaouais, Library, St.Jérôme, QC, Canada, 3McGill University, Ingram School of Nursing, Montreal, QC, Canada, 4University of Ottawa, School of Nursing, Ottawa, ON, Canada
1Université du Québec en Outaouais, Nursing, St.Jérôme, QC, Canada, 2Université du Québec en Outaouais, Library, St.Jérôme, QC, Canada, 3McGill University, Ingram School of Nursing, Montreal, QC, Canada, 4University of Ottawa, School of Nursing, Ottawa, ON, Canada
Presentation Documents
OBJECTIVES: Healthcare-associated infections (HCAIs) are common in long-term care facilities (LTCFs) and cause significant burden. Infection prevention and control (IPC) measures include the clinical best practices (CBPs) of hand hygiene, hygiene and sanitation, screening, and basic and additional precautions. Few studies demonstrate their cost-effectiveness in LTCFs, 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 study is to conduct a systematic review of economic evaluations of CBPs applied in LTCFs.
METHODS: We twice queried CINAHL, Cochrane, EconLit, Embase, Medline, Web of Science and Scopus for studies published between 1995 and 2024 of economic evaluations of CBPs in LTCFs. We included randomized controlled clinical trials, cohort, longitudinal, prospective, retrospective, cross-sectional, and simulation studies, as well as those based on 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 Dominance Ranking Matrix classification tool was used to determine if interventions should be rejected, favored, or if the decision remained unclear. The protocol of this review was registered and published.
RESULTS: From two searches 4,153 records were retrieved. After removal of duplicates and screening, 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 of 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 CBPs associated with IPC are clinically effective in LTCFs, and six demonstrated their cost-effectiveness.
CONCLUSIONS: Ongoing economic evaluation research of IPC remains essential to underpin healthcare policy choices guided by empirical evidence for LTCF residents and staff.
METHODS: We twice queried CINAHL, Cochrane, EconLit, Embase, Medline, Web of Science and Scopus for studies published between 1995 and 2024 of economic evaluations of CBPs in LTCFs. We included randomized controlled clinical trials, cohort, longitudinal, prospective, retrospective, cross-sectional, and simulation studies, as well as those based on 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 Dominance Ranking Matrix classification tool was used to determine if interventions should be rejected, favored, or if the decision remained unclear. The protocol of this review was registered and published.
RESULTS: From two searches 4,153 records were retrieved. After removal of duplicates and screening, 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 of 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 CBPs associated with IPC are clinically effective in LTCFs, and six demonstrated their cost-effectiveness.
CONCLUSIONS: Ongoing economic evaluation research of IPC remains essential to underpin healthcare policy choices guided by empirical evidence for LTCF residents and staff.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE348
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Infectious Disease (non-vaccine)