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Updated: Jul 5, 2026
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Published on: February 24, 2026
Cost-effectiveness of a practical approach to prevent respiratory infection outbreaks in long-term care settings: The
Naoki Takayama1, Mayumi Aminaka2, Haruyo Sakaki3
1Department of Infection Control and Prevention, NHO Tenryu Hospital, Hamamatsu, Shizuoka, Japan.
Background:
Respiratory infection outbreaks often occur in long-term care (LTC) settings and can disrupt health care delivery, including admissions and visitation.
Methods:
This study evaluated the cost-effectiveness of the Concurrent Approach for Respiratory Epidemiological Surveillance and Symptom Screening (CARES), which integrates patient syndromic surveillance with staff and visitor symptom screening. We compared two 6-month periods in 2 wards of a single LTC hospital, including 202 patients (98 non-CARES; 104 CARES). Staff time was assessed using time-motion observations. Incremental effectiveness was measured as reductions in ward-level calendar days under facility-mandated admission suspension, defined as the temporary suspension of new admissions, and visitation restriction, defined as the temporary restriction of family and visitor access.
Results:
Admission suspension decreased from 16 days in the non-CARES period to 0 days in the CARES period, and visitation restriction decreased from 23 days to 0 days. Incremental cost-effectiveness ratios were US $115.48 per day of admission suspension avoided and US $80.34 per day of visitation restriction avoided.
Discussion:
CARES demonstrated operational efficiency and measurable benefits in maintaining health care access and patient-family interaction.
Conclusions:
CARES may be an economically feasible and practical strategy that helps preserve quality of life and supports sustainable infection prevention in LTC settings.
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