Using health economics to improve resource allocation decisions relating to Clostridium difficile

David Brain 1

Phd Scholar, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia


Healthcare decision-makers are increasingly expected to balance a greater demand for health services with a finite budget. Despite the solid evidence about the epidemiology of Clostridium difficile infection, there is no understanding of the economic cost of the infection in the Australian healthcare setting. This study aimed to provide infection control decision-makers with novel and pragmatic information to help improve the management of the infection.

A model-based economic evaluation was undertaken to identify the most cost-effective healthcare intervention relating to the reduction of Clostridium difficile infection. The study evaluated ten (10) intervention scenarios, comparing both stand-alone and bundled interventions to reflect clinical reality. Thorough micro-costing methods were used to inform the model’s cost-related parameters.

Improving hospital hygiene by implementing a hand hygiene and environmental cleaning bundle yielded the greatest net monetary benefit of all interventions considered. It remained the optimal intervention under various scenario analyses. The results also show that there is an economic benefit to implementing infection control interventions in bundles rather than as stand-alone interventions, supporting current wisdom in the infection control community.

The findings from this study provide healthcare decision-makers with new information about the allocation of scarce resources. Infection control practitioners can use the results as evidence for investment in specific clinical activities in order to improve and target the prevention of this important public health problem.

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