TY - JOUR
T1 - Evaluating the cost implications of integrating SARS-CoV-2 genome sequencing for infection prevention and control investigation of nosocomial transmission within hospitals
AU - Panca, Monica
AU - Blackstone, James
AU - Stirrup, Oliver
AU - Cutino-Moguel, Maria-Teresa
AU - Snell, Luke Blagdon
AU - Thomson, Emma C
AU - Peters, Christine
AU - Nebbia, Gaia
AU - Holmes, Alison H.
AU - Chawla, Anu
AU - Machin, Nicholas
AU - Taha, Yusri
AU - Mahungu, Tabitha W
AU - Saluja, Tranprit
AU - de Silva, Thushan I
AU - Saeed, Kordo
AU - Pope, Cassie F
AU - Shin, Gee Yee
AU - Williams, Rachel
AU - Darby, Alistair
AU - Smith, Darren L.
AU - Loose, Matthew
AU - Robson, Samuel C
AU - Laing, Kenneth
AU - Partridge, David G
AU - Price, James Richard
AU - Breuer, Judith
N1 - Funding Information:
Members of different teams who provided data:, Infection Prevention and Control: M. Cummins (Barts Health NHS Trust, London, UK); G. Mollett, A. Marek (NHS Greater Glasgow and Clyde, Glasgow, UK); C. Beviz, H. Mitchell (Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK); B. Taylor, D. Lankstead (Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK); K. Wylie (Manchester University NHS Foundation Trust, Manchester, UK); A. Cobb (Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK); E. Baxter (Nottingham University Hospitals NHS Trust, Nottingham, UK); D. Thomlinson (City Hospital, Birmingham, UK); L. Hail (University College London Hospitals NHS Foundation Trust, London, UK). Income, Contracting and Costing: D. Jaramillo (Barts Health NHS Trust, London, UK); J. Haughney (NHS Greater Glasgow and Clyde, Glasgow, UK); S. Mookerjee (Imperial College Healthcare NHS Trust, London, UK); P. Dudley, C. Wilson (Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK); J. Field (Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK). Laboratories: A. Da Silva Filipe, D. Macpherson, D. Mair (NHS Greater Glasgow and Clyde, Glasgow, UK); C. McCann (Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK); J. Schutter (University of Sheffield, Sheffield, UK); K. Laing (St George's University Hospitals NHS Foundation Trust, London, UK); A. Beckett (Centre for Enzyme Innovation, University of Portsmouth, Portsmouth, UK); S. Glaysher (Portsmouth Hospitals University NHS Trust, Portsmouth, UK); K.F. Cook, C. Fearn, S. Goudarzi, H. Dent, H. Paul (School of Pharmacy and Biomedical Science & School of Biological Sciences, University of Portsmouth, Portsmouth, UK). K. Saeed would like to thank M. Connell, B. James and other colleagues in the Costing/Central Management Accounting Team at University Hospital Southampton as well as J. Brookes, S. Dailly, S. Jeremiah, J. Prieto, C. Holmes, T. Julius, A. Elliott, P. Doherty, K. Chandler, D. Court, S. Aplin and other colleagues in infection prevention at University Hospital Southampton for all their support during those challenging times and providing some of the interviews and costing calculations for the study.
Funding Information:
The study was funded by UK Research and Innovation and the Wellcome Trust through the COG-UK Consortium grant. J. Breuer receives funding from the National Institute for Health Research UCL/UCLH Biomedical Research Centre.
Publisher Copyright:
© 2023 The Authors
PY - 2023/9
Y1 - 2023/9
N2 - Background: The COG-UK hospital-onset COVID-19 infection (HOCI) trial evaluated the impact of SARS-CoV-2 whole-genome sequencing (WGS) on acute infection, prevention, and control (IPC) investigation of nosocomial transmission within hospitals. Aim: To estimate the cost implications of using the information from the sequencing reporting tool (SRT), used to determine likelihood of nosocomial infection in IPC practice. Methods: A micro-costing approach for SARS-CoV-2 WGS was conducted. Data on IPC management resource use and costs were collected from interviews with IPC teams from 14 participating sites and used to assign cost estimates for IPC activities as collected in the trial. Activities included IPC-specific actions following a suspicion of healthcare-associated infection (HAI) or outbreak, as well as changes to practice following the return of data via SRT. Findings: The mean per-sample costs of SARS-CoV-2 sequencing were estimated at £77.10 for rapid and £66.94 for longer turnaround phases. Over the three-month interventional phases, the total management costs of IPC-defined HAIs and outbreak events across the sites were estimated at £225,070 and £416,447, respectively. The main cost drivers were bed-days lost due to ward closures because of outbreaks, followed by outbreak meetings and bed-days lost due to cohorting contacts. Actioning SRTs, the cost of HAIs increased by £5,178 due to unidentified cases and the cost of outbreaks decreased by £11,246 as SRTs excluded hospital outbreaks. Conclusion: Although SARS-CoV-2 WGS adds to the total IPC management cost, additional information provided could balance out the additional cost, depending on identified design improvements and effective deployment.
AB - Background: The COG-UK hospital-onset COVID-19 infection (HOCI) trial evaluated the impact of SARS-CoV-2 whole-genome sequencing (WGS) on acute infection, prevention, and control (IPC) investigation of nosocomial transmission within hospitals. Aim: To estimate the cost implications of using the information from the sequencing reporting tool (SRT), used to determine likelihood of nosocomial infection in IPC practice. Methods: A micro-costing approach for SARS-CoV-2 WGS was conducted. Data on IPC management resource use and costs were collected from interviews with IPC teams from 14 participating sites and used to assign cost estimates for IPC activities as collected in the trial. Activities included IPC-specific actions following a suspicion of healthcare-associated infection (HAI) or outbreak, as well as changes to practice following the return of data via SRT. Findings: The mean per-sample costs of SARS-CoV-2 sequencing were estimated at £77.10 for rapid and £66.94 for longer turnaround phases. Over the three-month interventional phases, the total management costs of IPC-defined HAIs and outbreak events across the sites were estimated at £225,070 and £416,447, respectively. The main cost drivers were bed-days lost due to ward closures because of outbreaks, followed by outbreak meetings and bed-days lost due to cohorting contacts. Actioning SRTs, the cost of HAIs increased by £5,178 due to unidentified cases and the cost of outbreaks decreased by £11,246 as SRTs excluded hospital outbreaks. Conclusion: Although SARS-CoV-2 WGS adds to the total IPC management cost, additional information provided could balance out the additional cost, depending on identified design improvements and effective deployment.
UR - http://www.scopus.com/inward/record.url?scp=85164669287&partnerID=8YFLogxK
U2 - 10.1016/j.jhin.2023.06.005
DO - 10.1016/j.jhin.2023.06.005
M3 - Article
SN - 0195-6701
VL - 139
SP - 23
EP - 32
JO - Journal of Hospital Infection
JF - Journal of Hospital Infection
ER -