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. 2019 Nov 7;14(11):e0224142.
doi: 10.1371/journal.pone.0224142. eCollection 2019.

Estimating the national cost burden of in-hospital needlestick injuries among healthcare workers in Japan

Hiroyuki Kunishima  1 , Emiko Yoshida  2 , Joe Caputo  3 , Hiroshige Mikamo  4
Affiliations

Estimating the national cost burden of in-hospital needlestick injuries among healthcare workers in Japan

Hiroyuki Kunishima et al. PLoS One. .

Abstract

Background: Needlestick injury (NSI) is one of the most burdensome professional hazards in any medical setting; it can lead to transmission of fatal infectious diseases, such as hepatitis B, hepatitis C and human immunodeficiency virus. In the United States, the annual cost burden was estimated as somewhere between $118 million to $591 million; in the United Kingdom it is approximated to be £500,000 (US$919,117.65) per the National Health Service.

Method: This is the first published paper on the national cost burden of NSIs in Japan. A systematic literature review was conducted to review previous study design in global studies and to extract parameter values from Japanese studies. We conducted abstract searches through PubMed and the Japan Medical Abstracts Society (Ichushi), together with grey literature and snowball searches. A simple economic model was developed to calculate cost burden of NSIs from a societal perspective over a one-year time horizon. We assumed all NSIs are reported and perfect adherence in post NSI management that presented in the labour compensation scheme. Local guidelines were also referenced to extract resource utilization. Lastly, a deterministic sensitivity analysis was conducted and a scenario analysis which considered a payer perspective was also included.

Result and conclusion: The national cost burden of in-hospital NSIs is estimated as ¥33.4 billion (US$302 million) annually, based on an average cost per NSI of ¥63,711 (US$577) and number of NSIs at 525,000/year. 70% of the cost is due to initial laboratory tests, followed by productivity loss, estimated at 20% of the total cost. Cost of contaminated NSIs remains at 5% of the total cost. Change in number of NSIs significantly influences outcomes. Variation in post-exposure management practices suggests a need for NSI specific National guidelines and holistic labour compensation scheme development in Japan.

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Conflict of interest statement

JC and EY are specialist research consultants and were funded by Nippon Becton Dickinson Company, Ltd. (BD) to conduct this study. It was agreed that 1) no BD employee to be involved in decision making through conduct of the research, and 2) a conference presentation at JHEA and manuscript publication would take place regardless of study outcomes. Funding support does not alter our adherence to PLOS ONE policies on sharing data and materials. There is no restriction on sharing data and materials related to this study upon request from PLOS ONE.

Figures

Fig 1
Fig 1. Result of SLR for model design.
Fig 2
Fig 2. Result of SLR for parameter value.
Fig 3
Fig 3. Model structure.
See this image and copyright information in PMC

References

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    1. Hiramitsu Y. and Yoshikawa T., 針刺し・切創の未報告の有無に関する検証. Japan Medical Journal.2017;4874:42–46.
    1. United States General Accounting Office, Occupational Safety: Selected Cost and Benefit Implications of Needlestick Prevention Devices for Hospitals. 2000. Available from: https://www.gao.gov/new.items/d0160r.pdf.
    1. OECD, OECD Data. Available from: https://data.oecd.org/conversion/exchange-rates.htm.

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