Costs and savings associated with infection control measures that reduced transmission of vancomycin-resistant enterococci in an endemic setting

OBJECTIVE: To determine the costs and savings of a 15 component infection c ontrol program that reduced transmission of vancomycin-resistant enterococc i (VRE) in an endemic setting. DESIGN: Evaluation of costs and savings, using historical control data. SETTING: Adult oncology unit of a 650-bed hospital. PARTICIPANTS: Patients with leukemia, lymphoma, and solid tumors, excluding bone marrow transplant recipients. METHODS: Costs and savings with estimated ranges were calculated. Excess le ngth of stay (LOS) associated with VRE bloodstream infection (BSI) was dete rmined by matching VRE BSI patients with VRE-negative patients by oncology diagnosis. Differences in LOS between the matched groups were evaluated usi ng a mixed-effect analysis of variance linear-regression model. RESULTS: The cost of enhanced infection control strategies for 1 year was $ 116,515. VRE BSI was associated with an increased LOS of 13.7 days. The sav ings associated with fewer VRE BSI ($123,081), fewer patients with VRE colo nization ($2,755), and reductions in antimicrobial use ($179,997) totaled $ 305,833. Estimated ranges of costs and savings for enhanced infection contr ol strategies were $97,939 to $148,883 for costs and $271,531 to $421,461 f or savings. CONCLUSION: The net savings due to enhanced infection control strategies fo r 1 year was $189,318. Estimates suggest that these strategies would be cos t-beneficial for hospital units where the number of patients with VRE BSI i s at least six to nine patients per year or if the savings from fewer VRE B SI patients in combination with decreased antimicrobial use equalled $100,0 00 to $150,000 per year (Infect Control Hosp Epidemiol 2001;22:437-442).