Rhode Island Hospital researchers evaluate costs of Ebola

PROVIDENCE – A study by Rhode Island Hospital, a Lifespan entity, conservatively estimates that hospitals in the United States incurred a $360 million price tag, in responding to the Ebola crisis in 2014. That study, according to a statement from Lifespan, further recommends improvements to future public health preparedness practices regarding the efficient and appropriate allocation of resources.

Recently published in the medical journal, Infection Control and Hospital Epidemiology, the study was authored by Dr. Michael A. Smit, pediatric infectious diseases specialist and associate medical director, Rhode Island Hospital Department of Epidemiology & Infection Control, and Leonard A. Mermel, adult infectious diseases specialist and medical director of the hospital’s Department of Epidemiology & Infection Control. They collaborated with colleagues from The Joint Commission, University of Maryland Medical Center and Johns Hopkins Hospital on the study, “Ebola Preparedness Resources for Acute-Care Hospitals in the United States: A Cross-Sectional Study of Costs, Benefits, and Challenges.”

“With the massive effort across the country to ensure we were prepared for this often-deadly viral disease, there were wide variations in needs and approach, and it was our hope to learn more about potential efficiencies for future public health emergencies of this scope,” Smit said in a statement.

The researchers aimed to identify the costs for the supplies and staff overtime required for hospitals to prepare for the 2014 West African outbreak of the Ebola viral disease that threatened to become a global health crisis. In addition to costs, the survey – which collected information from more than 200 hospitals in 45 states and the District of Columbia – analyzed challenges, benefits and perceived value of preparedness efforts.

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The survey found these key outcomes:

  • The overall cost for the nation’s acute care hospitals to prepare for possible Ebola viral disease cases was estimated at $361,108,968;
  • On average, hospitals spent for supplies and overtime labor costs a total of $80,461;
  • Total supply and staff costs ranged from a per hospital low of $1,457 to a per hospital high of $760,367. Adjusted for bed count, those costs were between $159 and $250,000 per 100 beds;
  • Overtime cost in smaller hospitals was more than three-times greater than in larger hospitals;
  • Hospitals’ greatest challenge was difficulty obtaining supplies from vendors due to shortages; and their greatest benefit was better knowledge about personal protective equipment.

“Comparing costs, challenges and benefits, the majority of hospitals also provided positive assessments of the overall value of preparing for potential Ebola cases,” Barbara I. Braun, study co-investigator with The Joint Commission team, said in the statement.

Smit and Mermel concur that their study may reflect a conservative report on expenditures, as some costs associated with staff time, equipment and supplies may have been absorbed into general operations, rather than being attributed to Ebola preparation. But the lessons, they say, are notable.

“We hope that this work will assist us in future planning efforts,” Mermel said in the statement. “The financial impact of Ebola virus disease preparedness activities was substantial. The evidence makes a strong case that future emerging infectious disease identification, triage and management should be conducted at the regional and national levels to facilitate efficient and appropriate allocation of resources in acute care facilities.”

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