David Brain

Cost-effectiveness of a national initiative to improve hand hygiene compliance using the outcome of healthcare associated staphylococcus aureus bacteraemia

Background The objective is to estimate the incremental cost-effectiveness of the Australian National Hand Hygiene Inititiave implemented between 2009 and 2012 using healthcare associated Staphylococcus aureus bacteraemia as the outcome. Baseline comparators are the eight existing state and territory hand hygiene programmes. The setting is the Australian public healthcare system and 1,294,656 admissions from the 50 largest Australian hospitals are included. Methods The design is a cost-effectiveness modelling study using a before and after quasi-experimental design. The primary outcome is cost per life year saved from reduced cases of healthcare associated Staphylococcus aureus bacteraemia, with cost estimated by the annual on-going maintenance costs less the costs saved from fewer infections. Data were harvested from existing sources or were collected prospectively and the time horizon for the model was 12 months, 2011–2012. Findings No useable pre-implementation Staphylococcus aureus bacteraemia data were made available from the 11 study hospitals in Victoria or the single hospital in Northern Territory leaving 38 hospitals among six states and territories available for cost-effectiveness analyses. Total annual costs increased by

Economic Evaluation of Fecal Microbiota Transplantation for the Treatment of Recurrent Clostridium Difficile Infection in Australia.

2,851,475 for a return of 96 years of life giving an incremental cost-effectiveness ratio (ICER) of

Costing the Australian National Hand Hygiene Initiative.

29,700 per life year gained. Probabilistic sensitivity analysis revealed a 100% chance the initiative was cost effective in the Australian Capital Territory and Queensland, with ICERs of

Changes in healthcare-associated staphylococcus aureus bloodstream infections after the introduction of a national hand hygiene initiative

1,030 and

Economic evaluation of interventions designed to reduce Clostridium difficile infection

8,988 respectively. There was an 81% chance it was cost effective in New South Wales with an ICER of

Measuring costs and quality of life for venous leg ulcers

33,353, a 26% chance for South Australia with an ICER of

Response to Grayson's letter to the editor: 'Response to K. Page et al., 'Costing the Australian National Hand Hygiene Initiative''.

64,729 and a 1% chance for Tasmania and Western Australia. The 12 hospitals in Victoria and the Northern Territory incur annual on-going maintenance costs of

The role of time pressure and different psychological safety climate referents in the prediction of nurses’ hand hygiene compliance☆

1.51M; no information was available to describe cost savings or health benefits. Conclusions The Australian National Hand Hygiene Initiative was cost-effective against an Australian threshold of

The role of time pressure and different psychological safety climate referents in the prediction of nurses’ hand hygiene compliance

42,000 per life year gained. The return on investment varied among the states and territories of Australia.

Reducing length of stay to improve Clostridium difficile-related health outcomes

Clostridium difficile is the most common cause of hospital‐acquired diarrhea in Australia. In 2013, a randomized controlled trial demonstrated the effectiveness of fecal microbiota transplantation (FMT) for the treatment of recurrent Clostridium difficile infection (CDI). The aim of this study is to evaluate the cost‐effectiveness of fecal microbiota transplantation—via either nasoduodenal or colorectal delivery—compared with vancomycin for the treatment of recurrent CDI in Australia.