Financial and temporal costs of patient isolation in Norwegian hospitals

Abstract

Isolation of patients colonized or infected by antibiotic-resistant bacteria is an established infection-control measure taken in Norway. Local reliable data on the costs of this isolation are needed. A micro-costing study from a healthcare perspective was conducted on infectious disease wards in three general acute hospitals, utilising direct observation, staff registration, interviews and survey data. The daily additional cost of isolation was €56.8 (95% confidence interval (CI) 42.4-72.7) for non-bedridden patients and €87.5 (95% CI 48.3-129.6) for bedridden patients. Of these sums, labour costs accounted for the largest share (71-72%), followed by the costs of personal protective equipment (21-23%) and waste management (6-8%). Overall, isolation-specific workload amounted to 65 min/day for non-bedridden patients and 95 min/day for bedridden patients, predominantly in the form of extra time used by nurses. Higher isolation costs for bedridden patients were largely attributable to resources used for personal hygiene practices. One-time isolation costs incurred for room cleaning after patient discharge averaged at €14.0 (95% CI 10.7-17.6). Our study provides novel, detailed evidence on resource use attributable to patient isolation in hospitals that can be used to inform future assessments directed toward precautionary hygienic measures. Our results suggest that allocating additional nurse staffing to wards with large numbers of isolated patients should be considered.