About: The Costs of an Expanded Screening Criteria for COVID-19: A Modelling Study

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	The Costs of an Expanded Screening Criteria for COVID-19: A Modelling Study
Creator	Fisher, Dale Tambyah, Paul Cook, Alex Dickens, Borame Fisher, Paul Chai, Ann Yi, Louis Chai, Lim, Jue Dan, Dan, Dale Khoo, Ai Tambyah, Louis Yi, Ann Yock, Young
source	Elsevier; Medline; PMC
abstract	OBJECTIVES: Nosocomial infection is an ongoing concern in the COVID-19 outbreak. The effective screening of suspected cases in the healthcare setting is therefore necessary, enabling the early identification and prompt isolation of cases for epidemic containment. We aimed to assess the cost and health outcomes of an extended screening strategy, implemented in Singapore on 07 February 2020, which maximizes case identification in the public healthcare system. METHODS: We explored the effects of the expanded screening criteria which allows clinicians to isolate and investigate patients presenting with undifferentiated fever or respiratory symptoms or chest x-ray abnormalities. We formulated a cost appraisal framework which evaluated the treatment costs averted from the prevention of secondary transmission in the hospital setting, as determined by a branching process infection model, and compared these to the costs of the additional testing required to meet the criteria. RESULTS: In the base case analysis, an [Formula: see text] of 2.5 and incubation period of 4 days, an estimated 239 (95% CI: 201-287) cases could be averted over 150 days within the hospital setting through ESC. A corresponding $2.36 (2 – 2.85) million USD costs could be averted with net cost savings of $124 000 (95% CI: -334 000–516 000). In the sensitivity analyses, when positive identification rates (PIR) were above 7%, regardless of [Formula: see text] and incubation period, all scenarios were cost-saving. CONCLUSION: The expanded screening criteria can help to identify and promptly isolate positive COVID cases in a cost-saving manner or within acceptable cost margins where the costs incurred from the testing of negative patients could be negated by the averted costs. Outbreak control must be sustainable and effective; the proposed screening criteria should be considered to mitigate nosocomial transmission risk within healthcare facilities.
has issue date	2020-08-12(xsd:dateTime)
bibo:doi	10.1016/j.ijid.2020.08.025
bibo:pmid	32800857
has license	no-cc
sha1sum (hex)	466fd59071f46bab5214b5c6ca5edb5bcec72e26
schema:url	https://doi.org/10.1016/j.ijid.2020.08.025
resource representing a document's title	The Costs of an Expanded Screening Criteria for COVID-19: A Modelling Study
has PubMed Central identifier	PMC7422907
has PubMed identifier	32800857
schema:publication	Int J Infect Dis
resource representing a document's body	covid:466fd59071f46bab5214b5c6ca5edb5bcec72e26#body_text
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