Table 1. Evaluation of the effect of ILI-associated absenteeism among HCWs during the pandemic (H1N1) 2009 outbreak, Hospital das Clínicas, São Paulo, Brazil, May–October 2009*.
| Input | Value | Data source | Assumptions |
||
|---|---|---|---|---|---|
| Baseline cost | Lowest cost scenario | Highest cost scenario | |||
| No. physicians, nurses, and nurse assistants receiving ILI-associated sick leave |
415 for 2-d + reassessment; 169 for 7-d |
Centralized occupational health database |
NA |
NA |
NA |
| Costs | |||||
| Medical consultation | R$7.90/ consultation | National Health Care System | 1.1 consultations/ HCW for 7-d; 2.5/HCW for 2-d + reassessment | 1 consultation/HCW for 7-d; 1.5/HCW for 2-d + reassessment | 2.5 consultations/HCW for 7-d; 4/HCW for 2-d + reassessment |
| Transportation for consultation | R$10.00/round trip | Public transport fare | 10% returned for consultation for 7-d 1.5 returns/HCW for 2-d + reassessment | No return visits for 7-d; 0.5 returns/HCW for 2-d + reassessment | 1.5 returns for consultations for 7-d; 3 return visits for 2-d + reassessment |
| Oseltamivir treatment | R$112.40/ treatment | Central pharmacy | Received by 100% of HCWs with suspected influenza | Received by 100% of HCWs with suspected influenza | Received by 100% of HCWs with suspected influenza |
| Amoxicillin treatment | R$2.40/ treatment | Central pharmacy | Received by 20% of HCWs with suspected influenza. | Received by 5% of HCWs with suspected influenza | Received by 60% of HCWs with suspected influenza |
| Medication for symptoms | R$2.95/ treatment | Central pharmacy | Received by 70% of HCWs with suspected influenza | Received by 20% of HCWs with suspected influenza | Received by 100% of HCWs with suspected influenza |
| Diagnostic rt-PCR† | R$100.00/test | Central laboratory | NA | NA | NA |
| Swab for collecting
specimen for rt-PCR |
R$0.46/test |
Central laboratory |
NA |
NA |
NA |
| No. HCWs undergoing diagnostic rt-PCR† | 244 | Central laboratory | NA | NA | NA |
| No. HCWs hospitalized† | None | Nucleus of Information on Health Care | NA | NA | NA |
| No. d hospitalization of HCWs† |
30 d for 2-d + reassessment; 4 d for 7-d |
Direct review of patient records |
NA |
NA |
NA |
| Daily cost | |||||
| Hospitalization | R$1,196.39 for 2-d + reassessment; R$1,871.06 for 7-d | Administration | |||
| Staff replacement | Nurse: R$257.07; nurse assistant: R$167.09; physician: R$858.51 | Human resource department | 70% of nurses, 70% of nurse assistants, 50% of physicians replaced | 30% of nurses, 30% of nurse assistants, 10% of physicians replaced | 100% of nurses, 100% of nurse assistants, 80% of physicians replaced |
| Productivity losses | Nurse: R$307.15; nurse assistant: R$157.18; physician: R$381.23 | Human resource department | NA | NA | NA |
*ILI, influenza-like illness; HCW, health care worker; 2-d + reassessment, 2-day sick leave plus reassessment every 2 days until asymptomatic policy; 7-d, 7-day sick leave policy; NA, not applicable; R$, Brazilian reals (R$1.80 = US $1.00); rt-PCR, real-time PCR. †For pandemic (H1N1) 2009.