dc.contributor.author |
De Jager, P.
|
|
dc.contributor.author |
Zungu, Muzimkhulu
|
|
dc.contributor.author |
Dyers, R.E.
|
|
dc.date.accessioned |
2019-07-31T10:49:31Z |
|
dc.date.available |
2019-07-31T10:49:31Z |
|
dc.date.issued |
2018-06 |
|
dc.description.abstract |
BACKGROUND. Healthcare workers (HCWs) are at increased risk of contracting various communicable diseases. Needlestick injuries (NSIs)
are a common mechanism of exposure. Training in basic universal precautions and utilisation of safety-engineered devices (SEDs) are
interventions known to reduce the risk of NSI.
OBJECTIVES. To assess the cost-utility of SEDs v. a training programme in universal precautions (TP) v. a combination strategy to reduce
NSIs among South African HCWs.
METHODS. A Markov model comparing SEDs v. a TP v. a combination strategy against current practice was developed. A hypothetical cohort
of HCWs working in the SA public sector was followed from a payer’s perspective for a period of 45 years, and discounted costs and benefits
were assessed. Data were obtained from the National Department of Health, suppliers and published literature. One-way and probabilistic
sensitivity analysis was conducted.
RESULTS. Over the study time horizon, our model estimated that 2 209, 3 314 and 4 349 needlestick injuries per 1 000 HCWs could
be prevented if a TP, SEDs or a combination strategy, respectively, was adopted compared with current practice. All three candidate
interventions were cost-effective at a willingness to pay (WTP) of one times the gross domestic product per capita (USD6 483.90/qualityadjusted
life-year (QUALY) gained). SEDs as a stand-alone intervention was dominated by a combination strategy. Compared with current
practice, the incremental cost-effectiveness of training was USD32.90/QALY v. USD432.32/QALY for SEDs and USD377.08/QALY for a
combination strategy. Results were sensitive to the effectiveness of the interventions. Probabilistic sensitivity analysis showed that at a WTP
of USD6 483.90/QALY gained, a combination strategy would be cost-effective 95.4% of the time.
CONCLUSIONS. A combination strategy in which both SEDs and a TP are adopted is preferred. |
en_ZA |
dc.description.department |
School of Health Systems and Public Health (SHSPH) |
en_ZA |
dc.description.librarian |
am2019 |
en_ZA |
dc.description.sponsorship |
The School of Public Health at the University of the Witwatersrand
provided partial funding for this project. |
en_ZA |
dc.description.uri |
http://www.samj.org.za |
en_ZA |
dc.identifier.citation |
De Jager, P., Zungu, M. & Dyers, R.E. 2018, 'Economic evaluation of safety-engineered devices and training in reducing needlestick injuries among healthcare workers in South Africa', South African Medical Journal, vol. 108, no. 6, pp. 477-483. |
en_ZA |
dc.identifier.issn |
0256-9574 (print) |
|
dc.identifier.issn |
2078-5135 (online) |
|
dc.identifier.other |
10.7196/SAMJ.2018.v108i6.12913 |
|
dc.identifier.uri |
http://hdl.handle.net/2263/70837 |
|
dc.language.iso |
Afrikaans |
en_ZA |
dc.publisher |
Health and Medical Publishing Group |
en_ZA |
dc.rights |
© 2019, South African Medical Association. All rights reserved. This article is licensed under a Creative Commons Attribution-NonCommercial Works License (CC BY-NC 3.0). |
en_ZA |
dc.subject |
Healthcare workers (HCWs) |
en_ZA |
dc.subject |
Willingness to pay (WTP) |
en_ZA |
dc.subject |
Needlestick injuries |
en_ZA |
dc.subject |
Training programme |
en_ZA |
dc.title |
Economic evaluation of safety-engineered devices and training in reducing needlestick injuries among healthcare workers in South Africa |
en_ZA |
dc.type |
Article |
en_ZA |