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Volume 17, Number 8—August 2011
Research

Cost-effectiveness of Sick Leave Policies for Health Care Workers with Influenza-like Illness, Brazil, 2009

Nancy Val y Val P. Mota, Renata D. Lobo, Cristiana M. Toscano, Antonio C. Pedroso de Lima, M. Beatriz Souza Dias, Helio Komagata, and Anna S. LevinComments to Author 
Author affiliations: Author affiliations: Hospital das Clínicas, São Paulo, Brazil (N.V.V.P. Mota, R.D. Lobo, M.B. Souza Dias, H. Komagata, A.S. Levin); Federal University of Goiás, Goiânia, Brazil (C.M. Toscano); University of São Paulo, São Paulo (A.C. Pedroso de Lima, A.S. Levin)

Main Article

Table 1

Evaluation of the effect of ILI-associated absenteeism among HCWs during the pandemic (H1N1) 2009 outbreak, Hospital das Clínicas, São Paulo, Brazil, May–October 2009*

Input Value Data source Assumptions
Baseline cost Lowest cost scenario Highest cost scenario
No. physicians, nurses, and nurse assistants receiving ILI-associated sick leave
415 for 2-d + reassessment; 169 for 7-d
Centralized occupational health database
NA
NA
NA
Costs
Medical consultation R$7.90/ consultation National Health Care System 1.1 consultations/ HCW for 7-d;
2.5/HCW for 2-d + reassessment 1 consultation/HCW for 7-d; 1.5/HCW for 2-d + reassessment 2.5 consultations/HCW for 7-d; 4/HCW for 2-d + reassessment
Transportation for
consultation R$10.00/round trip Public transport fare 10% returned for consultation for 7-d
1.5 returns/HCW for 2-d + reassessment No return visits for 7-d; 0.5 returns/HCW for 2-d + reassessment 1.5 returns for consultations for 7-d; 3 return visits for 2-d + reassessment
Oseltamivir treatment R$112.40/ treatment Central pharmacy Received by 100% of HCWs with suspected influenza Received by 100% of HCWs with suspected influenza Received by 100% of HCWs with suspected influenza
Amoxicillin treatment R$2.40/ treatment Central pharmacy Received by 20% of HCWs with suspected influenza. Received by 5% of HCWs with suspected influenza Received by 60% of HCWs with suspected influenza
Medication for symptoms R$2.95/ treatment Central pharmacy Received by 70% of HCWs with suspected influenza Received by 20% of HCWs with suspected influenza Received by 100% of HCWs with suspected influenza
Diagnostic rt-PCR† R$100.00/test Central laboratory NA NA NA
Swab for collecting
specimen for rt-PCR
R$0.46/test
Central laboratory
NA
NA
NA
No. HCWs undergoing diagnostic rt-PCR† 244 Central laboratory NA NA NA
No. HCWs hospitalized† None Nucleus of Information on Health Care NA NA NA
No. d hospitalization of HCWs†
30 d for 2-d + reassessment; 4 d for 7-d
Direct review of patient records
NA
NA
NA
Daily cost
Hospitalization R$1,196.39 for 2-d + reassessment; R$1,871.06 for 7-d Administration
Staff replacement Nurse: R$257.07; nurse assistant: R$167.09; physician: R$858.51 Human resource department 70% of nurses, 70% of nurse assistants, 50% of physicians replaced 30% of nurses, 30% of nurse assistants, 10% of physicians replaced 100% of nurses, 100% of nurse assistants, 80% of physicians replaced
Productivity losses Nurse: R$307.15; nurse assistant: R$157.18; physician: R$381.23 Human resource department NA NA NA

*ILI, influenza-like illness; HCW, health care worker; 2-d + reassessment, 2-day sick leave plus reassessment every 2 days until asymptomatic policy; 7-d, 7-day sick leave policy; NA, not applicable; R$, Brazilian reals (R$1.80 = US $1.00); rt-PCR, real-time PCR.
†For pandemic (H1N1) 2009.

Main Article

Page created: August 15, 2011
Page updated: August 15, 2011
Page reviewed: August 15, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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