title: Do cost savings from reductions in nosocomial infections justify additional costs of single-bed rooms in intensive care units? A simulation case study.
abstract: OBJECTIVE
  Evidence shows that single-patient rooms can play an important role in preventing cross-transmission and reducing nosocomial infections in intensive care units (ICUs). This case study investigated whether cost savings from reductions in nosocomial infections justify the additional construction and operation costs of single-bed rooms in ICUs.
  
  
  METHODS
  We conducted deterministic and probabilistic return-on-investment analyses of converting the space occupied by open-bay rooms to single-bed rooms in an exemplary ICU. We used the findings of a study of an actual ICU in which the association between the locations of patients in single-bed vs open-bay rooms with infection risk was evaluated.
  
  
  RESULTS
  Despite uncertainty in the estimates of costs, infection risks, and length of stay, the cost savings from the reduction of nosocomial infections in single-bed rooms in this case substantially outweighed additional construction and operation expenses. The mean value of internal rate of return over a 5-year analysis period was 56.18% (95% credible interval, 55.34%-57.02%).
  
  
  CONCLUSIONS
  This case study shows that although single-patient rooms are more costly to build and operate, they can result in substantial savings compared with open-bay rooms by avoiding costs associated with nosocomial infections.
authors.affiliation: Department of Design and Environmental Analysis, Cornell University, Ithaca, NY. Electronic address: hs825@cornell.edu.
authors.forename: Hessam
authors.initials: H
authors.lastname: Sadatsafavi
authors.affiliation: Hormozgan University of Medical Sciences, Hormozgan, Iran. Electronic address: bahar.niknejad@gmail.com.
authors.forename: Bahar
authors.initials: B
authors.lastname: Niknejad
authors.affiliation: Department of Design and Environmental Analysis, Cornell University, Ithaca, NY. Electronic address: rzadeh@cornell.edu.
authors.forename: Rana
authors.initials: R
authors.lastname: Zadeh
authors.affiliation: Division of Respiratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada. Electronic address: msafavi@mail.ubc.ca.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Sadatsafavi
mesh_terms: D002170:Canada; D002177:Candidiasis / Q000191:economics / Q000517:prevention & control; D017046:Cost Savings / Q000191:economics*; D003428:Cross Infection / Q000191:economics* / Q000517:prevention & control; D017721:Hospital Costs; D006749:Hospital Design and Construction / Q000191:economics; D006801:Humans; D007362:Intensive Care Units / Q000191:economics*; D055624:Methicillin-Resistant Staphylococcus aureus; D018803:Models, Economic; D010362:Patients' Rooms / Q000191:economics*; D011552:Pseudomonas Infections / Q000191:economics / Q000517:prevention & control; D013203:Staphylococcal Infections / Q000191:economics / Q000517:prevention & control
keywords: Intensive care unit; Nosocomial infection control; Open-bay rooms; Return on investment; Single-bed rooms