Costing a major hospital outbreak of gastroenteritis due to Norovirus (Norwalk-like virus)

Abstract

O utbreaks of Norovirus infection in hospitals are common, but the financial impact is often poorly defined. Following a major outbreak, we propose a simple costing system. The key cost drivers identified were: 1. Lost bed days (LBDs) and cancelled elective surgical operations. The cost of an occupied or closed bed was £204 per day; 2. The period of staff sickness, estimated at an average of four days. Staff costs were estimated at £79.45 per day; 3. The employment of additional nurses; 4. Environmental cleaning (£200 per ward); 5. Additional microbiology costs (£8.27 per sample); 6. Ward consumable costs, estimated at £5 per ward per day.

The outbreak involved 16 wards, affecting 139 patients and 124 staff (mainly nurses) over a two week period. LBDs due to inpatient sickness amounted to £85,068. Lost days due to staff sickness cost £39,407. 150 cancelled surgical operations equates with 525 LBDs, costing £107,100. The cost of employing additional nursing staff was £41,465. Further costs included £3,200 for 16 ‘deep cleans', £560 for ward consumables, £1,150 for microbiology specimens and £1,165 for additional infection control hours. The total cost of the outbreak was estimated at £279,115. The costing model described quickly identified key financial pressures and could be applicable to other Norovirus outbreaks.