How Much do Needlestick Injuries Cost? A Systematic Review of the Economic Evaluations of Needlestick and Sharps Injuries Among Healthcare Personnel

Abstract

OBJECTIVETo provide an overview of the economic aspects of needlestick and sharps injury (NSI) management among healthcare personnel (HCP) within a Health Technology Assessment project to evaluate the impact of safety-engineered devices on health careMETHODSA systematic review of economic analyses related to NSIs was performed in accordance with the PRISMA statement and by searching PubMed and Scopus databases (January 1997–February 2015). Mean costs were stratified by study approach (modeling or data driven) and type of cost (direct or indirect). Costs were evaluated using the CDC operative definition and converted to 2015 International US dollars (Int$).RESULTSA total of 14 studies were retrieved: 8 data-driven studies and 6 modeling studies. Among them, 11 studies provided direct and indirect costs and 3 studies provided only direct costs. The median of the means for aggregate (direct + indirect) costs was Int$747 (range, Int$199–Int$1,691). The medians of the means for disaggregated costs were Int$425 (range, Int$48–Int$1,516) for direct costs (9 studies) and Int$322 (range, Int$152–Int$413) for indirect costs (6 studies). When compared with data-driven studies, modeling studies had higher disaggregated and aggregated costs, but data-driven studies showed greater variability. Indirect costs were consistent between studies, mostly referring to lost productivity, while direct costs varied widely within and between studies according to source infectivity, HCP susceptibility, and post-exposure diagnostic and prophylactic protocols. Costs of treating infections were not included, and intangible costs could equal those associated with NSI medical evaluations.CONCLUSIONSNSIs generate significant direct, indirect, potential, and intangible costs, possibly increasing over time. Economic efforts directed at preventing occupational exposures and infections, including provision of safety-engineered devices, may be offset by the savings from a lower incidence of NSIs.Infect Control Hosp Epidemiol 2016;37:635–646

Occupational blood exposures in health care workers: incidence, characteristics, and transmission of bloodborne pathogens in South Korea

“…These injuries result in 70,000 HBV infections, 15,000 HCV infections, and 500 HIV infections. Moreover, OBEs result in substantial psychological stress, such as job-related depression [3–5] and considerable management costs [6]. …”

Exposiciones a fluidos de riesgo en el personal de salud. Evaluación de gastos directos en su manejo

“…Una revisión sistemática efectuada en Italia, publicada en el año 2016, muestra costos significativos, tanto directos como indirectos, asociadas al manejo de las lesiones por aguja, 425 USD sólo por costo directo (rango 48 USD a 1.516 USD) y 747 USD por caso al considerar los costos agregados, por lo cual, los esfuerzos deben focalizarse en la prevención de estos eventos. También hace alusión a la incorporación de dispositivos de ingeniería de seguridad, cuyo gasto pudiese compensarse con los ahorros de una menor accidentabilidad 13, 23 . Estas cifras son superiores a las calculadas en nuestro estudio y cabe destacar que localmente no se ha evaluado el costo-beneficio del uso de dispositivos de seguridad.…”

Epidemiology of Needlestick and Sharps Injuries in Veterinary Medicine

“…However, a few studies have looked at the epidemiology of NSI and sharps injuries in veterinary practice. Despite signiicant efort for reduction, NSI and sharps injuries continue to pose a signiicant risk in human medicine [11], and a similar risk occurs in veterinary medicine. Reports carried out in small and large-animal practice show a large variability in the prevalence and incidence.…”

“…They include the direct costs associated with the initial and followup treatment when necessary [7 ], the emotional cost associated with fear and anxiety associated with the possible consequences of the injury, direct and indirect costs related with lost productivity and cost of any associated legal action [10,11]. Occupational hazards in the work of American veterinarians resulted in an estimated US$ million in losses [77], and the costs of injuries related to sharp contaminated instruments in the USA have been estimated to be around 11 1 million dollars in 2010 [7 ]. These costs associated with NSI can be reduced and healthcare protected with investment in safety-engineered sharp devices [7 ].…”