Economic evaluation of safety-engineered devices and training in reducing needlestick injuries among healthcare workers in South Africa
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 |