A Simulation-Based Cost-Effectiveness Analysis of Severe Acute Respiratory Syndrome Coronavirus 2 Infection Prevention Strategies for Visitors of Healthcare Institutions

Bartenschlager, Christina C.; Temizel, Selin; Ebigbo, Alanna; Gruenherz, Vivian; Gastmeier, Petra; Messmann, Helmut; Brunner, Jens O.; Römmele, Christoph

doi:10.1016/j.jval.2022.04.1736

Cited by 4 publications

(5 citation statements)

References 26 publications

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“…Data Science) zuzuordnen. Simulationsstudien wurden etwa zur Bettenkapazitätssteuerung in Krankenhäusern während der Pandemie [ 24 ], zur Evaluation von Besuchsmanagementstrategien in Gesundheitseinrichtungen [ 7 ] oder zur OP-Planung [ 48 ] eingesetzt. Vorteil von Computersimulationen ist es, dass auf der Basis von realen oder simulierten Daten verschiedene Entscheidungsalternativen bzw.…”

Section: Datenwissenschaftliche Evaluation Unterschiedlicher Zuteilun...unclassified

„Triagegesetz“ – Regelung mit fatalen Folgen

et al. 2023

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Mit dem Inkrafttreten von § 5c des Infektionsschutzgesetzes (IfSG), des sog. Triagegesetzes, am 14.12.2022 ist eine langwierige Diskussion zum vorläufigen Abschluss gekommen, mit deren Ergebnis Ärztinnen und Ärzte sowie Sozialverbände, aber auch Juristen und Ethiker gleichermaßen unzufrieden sind. Durch den ausdrücklichen Ausschluss des Abbruchs einer bereits begonnenen Behandlung zugunsten neuer Patient:innen mit besseren Erfolgsaussichten (Ex-post-Triage) werden Zuteilungsentscheidungen mit dem Ziel, möglichst vielen Patient:innen eine nutzbringende Teilhabe an der medizinischen Versorgung unter Krisenbedingungen zu ermöglichen, verhindert. Im Ergebnis folgt aus der neuen Regelung de facto eine „First-come-first-served“-Zuteilung, die mit der höchsten Mortalität auch bei Menschen mit Einschränkungen bzw. Behinderungen assoziiert ist und die in einer Bevölkerungsbefragung mit großem Abstand zu anderen Zuteilungsverfahren als unfair abgelehnt wurde. Zuteilungsentscheidungen einerseits nach Erfolgsaussicht vorzuschreiben, die aber nicht konsequent umgesetzt werden dürfen, und andererseits das Verbot, z. B. Alter und Gebrechlichkeit als Priorisierungskriterien anzuwenden, obwohl beide Faktoren die kurzfristige Überlebenswahrscheinlichkeit nach evidenter Datenlage am stärksten bestimmen, zeigen die Widersprüchlichkeit und Dogmatik der Regelung. Weiterhin bleibt nur die konsequente Beendigung nicht mehr indizierter und vom Patienten nicht (mehr) gewünschter Therapien, unabhängig von der aktuellen Ressourcenlage, möglich. Wenn aber in einer Krisensituation anders entschieden wird als in einer Situation ohne Ressourcenmangel, wäre dieses Vorgehen nicht gerechtfertigt und strafbewehrt. Entsprechend müssen höchste Ansprüche an eine rechtssichere Dokumentation gestellt werden, insbesondere im Stadium der dekompensierten Krisenversorgung einer Region. Das Ziel, möglichst vielen Patient:innen eine nutzbringende Teilhabe an der medizinischen Versorgung unter Krisenbedingungen zu ermöglichen, wird mit den Neuregelungen des Triagegesetzes jedenfalls konterkariert.

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Section: Datenwissenschaftliche Evaluation Unterschiedlicher Zuteilun...unclassified

„Triagegesetz“ – Regelung mit fatalen Folgen

et al. 2023

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“…Throughout the coronavirus disease 2019 (COVID-19) pandemic, environments with a high density of inhabitants, such as hospitals, assisted living facilities, cruise ships, schools, and universities have been identified as particularly prone to outbreaks . Close proximity and frequent interactions in those environments can facilitate the transmission of the etiological agent, that is, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). , Since 2020, various national and international guidance and policy documents have recommended continuous monitoring of such environs to minimize the emergence of local COVID-19 clusters and outbreaks. − Clinical diagnostics using antigen tests and nasopharyngeal swabbing proved successful in mitigating outbreaks by identifying and localizing symptomatic and asymptomatic virus carriers in universities − and hospitals . However, the invasive nature of nasal swabs, high per-person costs, and bottlenecks due to the limited capacities of test kits and the necessity for the cooperation of individuals make the continuous use of clinical diagnostic kits impractical for an endemic COVID-19 future …”

Section: Introductionmentioning

confidence: 99%

“…4−7 Clinical diagnostics using antigen tests and nasopharyngeal swabbing proved successful in mitigating outbreaks by identifying and localizing symptomatic and asymptomatic virus carriers in universities 8−10 and hospitals. 11 However, the invasive nature of nasal swabs, high per-person costs, and bottlenecks due to the limited capacities of test kits and the necessity for the cooperation of individuals make the continuous use of clinical diagnostic kits impractical for an endemic COVID-19 future. 12 Wastewater SARS-CoV-2 levels are well-established to reflect the SARS-CoV-2 burden in a population.…”

Section: ■ Introductionmentioning

confidence: 99%

Longitudinal Wastewater-Based Surveillance for SARS-CoV-2 in High-Density Student Dormitories in Singapore

Ng,

Kwok,

Hill

et al. 2024

ACS EST Water

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Environmental surveillance of wastewater from student dormitories was carried out over an academic year at a university campus in Singapore. From August 2021 to May 2022, SARS-CoV-2 RNA concentrations were quantified from concentrated 24-h composite wastewater samples collected twice weekly at 45 locations with sewer sheds serving between 400 and 1200 students. Two pilot studies using proxies for viral loading within the sanitary network were performed to determine the composite timings of the study. During the surveillance period, SARS-CoV-2 trends in campus wastewater levels closely resembled Singapore's combined national wastewater levels and clinical COVID-19 cases. In the examined sewer sheds, larger student populations significantly increased both the odds and duration of detecting SARS-CoV-2 RNA (p-value < 0.001 for both measures). However, the type of building corridor did not have a statistically significant impact on either the duration of detection (p-value = 0.716) or the odds of detecting the virus (p-value = 0.067). This study exemplifies the use of a decentralized and high-resolution surveillance system for the twice-weekly detection of viral shedding in high-density living conditions to support public health decisions and management.

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“…Despite more than 2 years having passed since the start of the health crisis, the economic and social levels reached in December 2019 have still not been achieved [ 21 , 22 , 23 ]. Although research efforts are being made extensively in this field, only a limited number of studies describing the economic impact of this disease are available [ 4 , 24 , 25 , 26 , 27 , 28 ]. There is considerable heterogeneity across costing methodologies (simulation, absolute costs, etc.).…”

Section: Introductionmentioning

confidence: 99%

“…There is considerable heterogeneity across costing methodologies (simulation, absolute costs, etc.). We observed a great variation in costs per patient, making comparison challenging even among countries with similar economic status [ 26 , 27 , 28 ]. However, no studies have performed a comparative analysis of ‘intra-hospital’ costs, especially for the costs incurred in important areas such as the emergency department, hospitalisation, and intensive care unit of the same hospital, between 2019 (pre-pandemic) and 2020 (first year of the pandemic).…”

Section: Introductionmentioning

confidence: 99%

Analysis of Healthcare Costs Incurred in Regional Hospitals in Andalusia (Spain) during the COVID-19 Pandemic

López-Villegas

Bautista-Mesa

Acosta-Robles

et al. 2022

IJERPH

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(1) Background: The global health crisis caused by the coronavirus disease (COVID-19) pandemic has led to extreme overloading of different public healthcare systems worldwide. The Spanish Public Healthcare System is one of them. This study aimed to conduct a comparative cost analysis to assess the impact of the COVID-19 pandemic on small- and medium-sized regional hospitals in Andalusia (Spain). (2) Methods: This comparative, multicentre, observational, and retrospective study was designed to perform a comparative cost analysis between the Alto Guadalquivir Health Agency (AGHA) and Poniente University Hospital (PUH), both of which belong to the Spanish Public Health System (PHS). The data included in this study corresponds to the total costs by area and year incurred by the 61,335 patients from both healthcare institutions (AGHA = 36,110; PUH = 25,225) in the areas of hospital emergency service (HES), hospitalisation, and intensive care unit (ICU), during the 24 months of the study period (from 1 January 2019 to 31 December 2020). (3) Results: The analysis results showed a significant increase in costs incurred in 2020 for HES relative to those incurred in 2019 for both AGHA (+14%; p < 0.003) and PUH (+36%; p = 0.002). Additionally, costs incurred for ICU increased significantly in 2020 relative to those incurred in 2019 for both AGHA (+30%; p = 0.003) and PUH (+46%; p = 0.002). Hospitalisation costs for AGHA also increased significantly (+9%; p < 0.012) in 2020 versus those obtained in 2019; however, no significant differences were found for PUH (+6%; p = 1) in the same period analysed. However, the number of patients treated in the areas of HES, hospitalisation, and ICU was significantly reduced throughout 2020 compared to 2019. (4) Conclusions: Our findings show that the costs incurred during 2020 in the regional hospitals of Andalusia (Spain) increased significantly in most of the parameters analysed relative to those incurred in the year before the pandemic (i.e., 2019).

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A Simulation-Based Cost-Effectiveness Analysis of Severe Acute Respiratory Syndrome Coronavirus 2 Infection Prevention Strategies for Visitors of Healthcare Institutions

Cited by 4 publications

References 26 publications

„Triagegesetz“ – Regelung mit fatalen Folgen

„Triagegesetz“ – Regelung mit fatalen Folgen

Longitudinal Wastewater-Based Surveillance for SARS-CoV-2 in High-Density Student Dormitories in Singapore

Analysis of Healthcare Costs Incurred in Regional Hospitals in Andalusia (Spain) during the COVID-19 Pandemic

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