Costs of Infection Control and Special Challenges during the Covid-19 Pandemic: Experiences in a Military Hospital

Abstract

Infection prevention and control (IPC) is a set of evidence-based practices of hospital epidemiology aiming to prevent and control healthcare-associated infections. The aim of the present study was two-fold. First, we estimated the costs of IPC in the Medical Centre of the Hungarian Defence Forces (MCHDF) in Hungary using a bottom-up microcosting approach. Second, we analysed how the involvement of the MCHDF in Covid-19 care changed the occurrence of multidrug-resistant infections in the hospital. Our results showed that depending on the type of ward, the daily costs of standard care ranged between 3,809–8,589 HUF, while the costs of isolation were between 9,203–11,200 HUF. Daily costs were highest in the intensive care unit (ICU). Total costs per patient ranged between 20,875–78,904 HUF for standard care and 79,996–282,892 HUF for isolation with highest values in the Neonatal Intensive Care Unit (NICU). The incremental isolation cost per patient compared to standard care ranged between 20,363–158,216 HUF. When the MCHDF became a Covid-19 care centre, the incidence of introduced Clostridium difficile and multidrug resistant cases increased by nearly 200 per cent and 40 per cent, respectively. Our results can be used as basic input data for the economic evaluation of IPC strategies and highlights an important IPC aspect to be considered for the redistribution of hospital capacities during the Covid-19 pandemic.