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The Real Cost of Outbreaks

Infectious disease outbreaks at healthcare facilities are a major problem for healthcare institutions as the cost of containment and control of these outbreaks can really add up.1

The usual culprits

The two predominant outbreak culprits are seasonal influenza (flu) and norovirus. Influenza and norovirus outbreaks are more prevalent in winter months due to changes in environmental conditions and in human behaviour.2 Eighty percent of norovirus outbreaks occur from November to April and records show that influenza activity peaks in February.2,3 Large hospitals tend to have several outbreaks per year, for example, a large Toronto hospital had 15 outbreaks in 2018 and 12 outbreaks in 2019, including influenza, norovirus, VRE, MRSA and C. difficile.4

The 2018 influenza season in Canada resulted in 1,778 outbreaks, of which 1,098 (62%) occurred in long-term care facilities.5

It all adds up  

In an analysis conducted at a large Toronto hospital, the following actual costs were calculated for different types of outbreaks: $115,871 for a 20-day outbreak of norovirus; $45,261 for an eight-day outbreak of influenza A; and $35,897 for an 18-day outbreak of VRE.4

C. difficile infections can be particularly costly. The majority of costs incurred are the direct result of extended hospital stays and hospitalization, with a mean cost of $11,930 for an initial episode and $15,330 for recurrent episodes.6

Fifty percent of the costs associated with outbreaks occur because of the closure of multiple wards leading to missed revenue; 17% for extra microbiological diagnostics; 11% due to contact or strict isolation of patients; 10% for extra personnel; 7% for other costs; and 5% due to extra cleaning on the affected wards.1 Additionally, the emergence of antibiotic resistant organisms (AROs) has also resulted in increased cost to the healthcare system. It is estimated that AROs increase the annual direct and indirect costs to patients by an additional $40 to $52 million in Canada.7

Let’s talk about prevention

According to a report by the Provincial Infectious Disease Advisory Committee (PIDAC), 20% of healthcare-associated infections could be prevented through infection, prevention and control (IPAC) strategies.8 The report also shows that IPAC programs are both clinically effective and cost-effective.

Preventing and controlling outbreaks require a multifaceted approach, including vaccination (where applicable), isolation precautions (minimizing patient movement within wards, closure of wards), promotion of adherence to hand hygiene, use of personal protective equipment, and implementing enhanced environmental surface and cleaning disinfecting protocols.9  

Significant savings seen with prevention:

$650,000 – Cost of norovirus outbreak at a large, 946-bed US hospital10

$115,871 – Cost for a 20-day outbreak of norovirus at a large Toronto hospital4

$99,363 – Savings resulting from increased surface disinfection following an outbreak of just five cases of norovirus11

$104,273 – Savings resulting from enhanced hand hygiene measures following an outbreak of just five cases of norovirus11

Your prevention partners

CloroxPro™ offers multiple Health Canada-registered disinfectants based on three chemistries: hydrogen peroxide, quat and bleach, to help meet your facility’s unique needs.  

Get in touch

To get more information either email us, or click on the contact us tab for more options.

References:

  1. Dik J-W H, et al. Cost-analysis of seven nosocomial outbreaks in an academic hospital. PLoS ONE 2016;11(2):e0149226. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4749280/
  2. Norovirus NoroSTAT Data. Centers for Disease Control and Prevention. https://www.cdc.gov/norovirus/reporting/norostat/data.html Accessed January 14, 2020.
  3. The Flu Season. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/about/season/flu-season.htm Accessed January 14, 2020.
  4. Rogers B, et al. Outbreak cost analysis: The development of a tracking mechanism to calculate the financial impact on unit-based outbreaks in an acute care facility. Infection Prevention and Control Canada. 2019 IPAC Canada Webinar: October 2019. https://ipac-canada.org/webinar-cost-of-outbreaks.php. Accessed January 6, 2020.
  5. Government of Canada. FluWatch report: April 22, 2018 to April 28, 2018 (week 17). https://www.canada.ca/en/public-health/services/publications/diseases-conditions/fluwatch/2017-2018/week17-april-22-28-2018.html. Accessed January 14, 2020.
  6. Levy AR, et al. Incidence and costs of Clostridium difficile infections in Canada. Open Forum Infect Dis 2015;2(3):ofv076. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4503917/
  7. Birnbaum D. Antimicrobial resistance: a deadly burden no country can afford to ignore. Can Commun Dis Rep 2003;29(18):157-64. https://www.ncbi.nlm.nih.gov/pubmed/14524197
  8. Ontario Agency for Health Protection and Promotion. Provincial Infectious Diseases Advisory Committee. Best Practices for Infection Prevention and Control Programs in All Health Care Settings, 3rd edition. Toronto, ON: Queen’s Printer for Ontario; May 2012. https://www.publichealthontario.ca/-/media/documents/B/2012/bp-ipac-hc-settings.pdf?la=en
  9. Key infection control recommendations for the control of norovirus outbreaks in healthcare settings. https://www.cdc.gov/hai/pdfs/norovirus/229110a-noroviruscontrolrecomm508a.pdf  Accessed January 14, 2020.
  10. Johnston C, et al. Outbreak management and implications of a nosocomial norovirus outbreak. Clin Infect Dis 2007;45(5):534-40. https://www.ncbi.nlm.nih.gov/pubmed/17682985
  11. Lee B, et al. Economic value of norovirus outbreak control measures in healthcare settings. Clin Microbiol Infect 2010;17(4):640-6. https://pubmed.ncbi.nlm.nih.gov/20731684/