The direct costs of universal precautions in a teaching hospital.
An analysis of the increase in expenditures for barrier isolation materials before and after the institution of universal precautions at our 900-bed university hospital was used to generate a national estimate of the cost of implementation of the new Centers for Disease Control guidelines. Following the institution of universal precautions, use of rubber gloves at our hospital increased from 1.64 million pairs of 2.81 million pairs annually. A 5-year review of hospital purchasing and supply records in both inpatient and outpatient areas indicated that the total annual costs for isolation materials increased by $350,900. This represented an increase from $13.70 to $22.89 per admission (60%) after adjustment for inflation. The cost of isolation materials increased from $98 to $215 per 1000 outpatient visits, an adjusted increase of 92%. Two thirds of the increase (64%) was due to rubber gloves and an additional 25% was due to disposable isolation gowns. Universal precautions are estimated to have cost at least $336 million in the United States in fiscal year 1989 after adjustment for inflation. If expenditures for isolation materials at our medical center are representative, previous estimates may have significantly underestimated costs nationwide.
Doebbeling
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BN
Department of Internal Medicine, University of Iowa College of Medicine, Iowa City 52242.
Wenzel
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RP
D002487:Centers for Disease Control and Prevention, U.S.; D003140:Communicable Disease Control / Q000191:economics*; D003365:Costs and Cost Analysis / Q000639:trends; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D004209:Disposable Equipment / Q000191:economics; D005932:Gloves, Surgical / Q000191:economics / Q000706:statistics & numerical data; D006746:Hospital Bed Capacity, 500 and over; D006784:Hospitals, Teaching / Q000191:economics*; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D010356:Patient Isolation / Q000191:economics; D010564:Personnel, Hospital / Q000193:education / Q000706:statistics & numerical data*; D011159:Population Surveillance; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000191:economics; D014481:United States