Cost-consequence analysis of influenza vaccination among the staff of a large teaching hospital in Rome, Italy: A pilot study.

Americo Cicchetti,Andrea Gentili,Sergio Riccardo Mastrodonato,Roberta Galluzzi,Filippo Berloco,Andrea Tamburrano,Daniele Piacentini,Andrea Cambieri,Walter Ricciardi,Vittoria Colamesta,Shinya Tsuzuki,Andrea Barbara,Patrizia Laurenti,Daniele Ignazio La Milia

doi:10.1371/journal.pone.0225326

Abstract

Flu vaccination, as well as being effective to prevent seasonal influenza, decreases staff illness and absenteeism and reduces costs resulting from loss of productivity. Despite the effectiveness of flu vaccination, the seasonal coverage among healthcare workers is usually low. The aim of this retrospective observational study was to analyze the vaccination coverage rate among all employees (healthcare workers and administrative staff) of a large teaching hospital in Rome during the 2017–2018 influenza season, to perform a cost-consequence analysis of influenza vaccination (by evaluating the absenteeism due to illness in the epidemic period), and to assess the impact of vaccination in terms of both costs and sick days. The flu vaccination coverage rate was 9.8% among 4631 healthcare workers and 852 administrative employees. The human capital approach estimated a loss of productivity equal to 297.06 € for each vaccinated worker and 517.22 € for each unvaccinated worker (cost-outcome ratio: 120.07 €/sick day). Applying the friction cost method, a loss of productivity equal to 237.65 € for each vaccinated worker and 413.78 € for each unvaccinated worker (cost-outcome ratio: 104.19 €/sick day) was found. These results confirm the benefits of the flu vaccination for the society and the company. This allowed the management to grant one hour of permission to the flu-vaccinated workers in the following annual vaccination campaign (2018–2019).

Highlights

The World Health Organization (WHO) recommends flu vaccination both in groups considered to be at high risk of exposure to the influenza virus and in those at risk of developing severe disease, including healthcare workers (HCWs), pregnant women, children aged between 6 months to 5 years, elderly individuals and individuals with underlying health conditions such as HIV/AIDS, asthma, and chronic heart or lung diseases [6]
Even in Italy, following the WHO advice, the National Vaccine Prevention Plan (Piano Nazionale Prevenzione Vaccinale– PNPV) 2017–2019 strongly recommends the flu vaccine to elderly, people suffering from specific conditions of risk and HCWs with the goal to achieve the 75% flu vaccination coverage, as minimum target, and 95% as optimal one [7]
The teaching hospital counted 5,483 hospital workers employed and all of them were included in the study

Summary

Introduction

Strategies to improve confidence in vaccines should involve political, social, cultural and economic framework [5]. In this perspective, the WHO recommends flu vaccination both in groups considered to be at high risk of exposure to the influenza virus and in those at risk of developing severe disease, including healthcare workers (HCWs), pregnant women, children aged between 6 months to 5 years, elderly individuals (aged more than 65 years) and individuals with underlying health conditions such as HIV/AIDS, asthma, and chronic heart or lung diseases [6]. Even in Italy, following the WHO advice, the National Vaccine Prevention Plan (Piano Nazionale Prevenzione Vaccinale– PNPV) 2017–2019 strongly recommends the flu vaccine to elderly, people suffering from specific conditions of risk (diabetes, cardiovascular and respiratory diseases, cancer, etc.) and HCWs with the goal to achieve the 75% flu vaccination coverage, as minimum target, and 95% as optimal one [7]

Objectives

Methods

Results

Discussion

Conclusion