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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.

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