Browsing by Author "Sharma, Anuj"

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    Economic Analysis of Near-Patient Testing for C. difficile Implemented in a Large Hospital in Calgary, Canada
    (2020-06-19) Sharma, Anuj; Hollis, Aidan; Lu, Mingshan; Walls, William David; Laliberté, Jean William P.
    Clostridium difficile infection (CDI) is the main source for onset of antibiotic-associated diarrhea in patients and is thus an important cause of morbidity and mortality in Canadian hospitals. CDI typically results from the augmented and needless use of potent broad-spectrum antibiotics. All patients suspected of CDI are put under mandatory pre-emptive contact precautions even before patients are tested for CDI. The contact precautions involve use of fresh gown and gloves for each entry into a patient room. Most patients with a suspected diagnosis of CDI ultimately test negative. The existing centralized testing takes about 24 hours for test result confirmation. Consequently, hospitals are burdened with unnecessary cost of putting such patients under contact precautions and patients who test positive face a delay in appropriate therapy initiation. There is a rapid test available for diagnosing CDI which gives results within a few hours, but it is more expensive than the centralized testing. This thesis offers an economic analysis of rapid testing for CDI in Calgary, Alberta. Existing literature on implementation of rapid testing lack accurate cost-benefit analysis. In my thesis, I have focused only on patients who test negative. The hypothesis is that for patients with a negative diagnosis, rapid testing may enable early removal from contact precautions for patients who do not have any other diseases which requires contact precautions, saving the hospital the cost of contact precautions. The analysis in this thesis suggests that by implementing rapid testing for diagnosing CDI, Foothills Medical Center in Calgary, Canada can save approximately $20,000 annually.