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Cost of measles containment in an ambulatory pediatric clinic
Kristen A Wendorf1, Meagan Kay, Ismael R Ortega-Sanchez
1From the *Communicable Disease Epidemiology & Immunization Section, Public Health-Seattle & King County, Seattle, WA; †Epidemic Intelligence Service, Centers for Disease Control and Prevention; ‡Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention; and §Council of State and Territorial Epidemiologists, Atlanta, GA.
Background:
Measles is highly infectious; prompt containment of illnesses is necessary to prevent spread. In August 2013, a 13-year-old male with measles exposed patients and employees in a pediatric clinic. We studied containment costs to identify avoidable costs.
Methods:
Measles exposure was defined as in-person contact with or presence in the same room <2 hours after the measles patient. Costs were calculated retrospectively using published costs of measles-mumps-rubella vaccine, cost-to-charge ratios for inpatient care in urban Washington State and local emergency department charges for post-exposure immunoglobulin (IG). Personnel costs were calculated by multiplying hourly wages by time for employees who worked on the response; overhead was excluded.
Results:
Fifty-two patients, 60 caretakers and 10 employees were exposed. Personnel time cost $1961. Exposed patients had a mean age of 9.6 years (range: 2 months-19 years); 34 (65%) were fully vaccinated, and 18 (35%) were <12 months of age and too young to be vaccinated. Five patients (10%) were <6 months of age and required IG; 13 infants (25%) 6-11 months of age required measles-mumps-rubella vaccination. Caretakers followed up with their physicians for evidence of immunity. One employee had documented evidence of immunity; 9 required measles antibody testing or vaccination. Management of exposed persons cost $3694; overall clinic costs were $5655.
Conclusion:
Responding to 1 measles case cost the pediatric clinic more than $5000, despite isolating the patient promptly after examination. Documentation of employee immunity, vaccination of eligible patients and strict infection control precautions might reduce ambulatory costs associated with measles containment.
Insights
A single measles case cost a pediatric clinic over $5,000. Prompt containment and infection control measures, including employee immunity documentation and eligible patient vaccination, can reduce measles outbreak costs.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Healthcare Management
Background:
- Measles is a highly contagious viral illness requiring rapid containment to prevent outbreaks.
- A pediatric clinic experienced a measles exposure event in August 2013 involving a 13-year-old male patient.
- The study aimed to analyze the costs associated with measles containment to identify potential cost savings.
Purpose of the Study:
- To quantify the financial costs incurred by a pediatric clinic in response to a single measles case.
- To identify specific cost drivers within the measles containment process.
- To suggest strategies for reducing ambulatory costs during measles containment.
Main Methods:
- Retrospective cost analysis of a measles exposure incident.
- Defined measles exposure as in-person contact or same-room presence within 2 hours of the infectious patient.
- Calculated costs using published vaccine prices, cost-to-charge ratios for inpatient care, and local emergency department charges for post-exposure immunoglobulin (IG).
- Personnel costs were based on hourly wages and time spent on response activities, excluding overhead.
Main Results:
- The measles exposure involved 52 patients, 60 caretakers, and 10 employees.
- Personnel time costs amounted to $1,961, with overall management costs reaching $3,694, totaling $5,655 for the clinic.
- Of the exposed patients, 35% were under 12 months and too young for vaccination, with 10% requiring IG and 25% needing measles-mumps-rubella vaccination.
Conclusions:
- Containment of a single measles case incurred significant costs exceeding $5,000 for the pediatric clinic.
- Strategies such as verifying employee immunity, vaccinating eligible patients, and implementing strict infection control can mitigate measles containment expenses.
- Proactive measures are crucial for reducing the financial burden of measles outbreaks in healthcare settings.
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