What are the costs and benefits of patient notification exercises following poor infection control practices in dentistry?

Public Health. 2013 Nov;127(11):1021-7. doi: 10.1016/j.puhe.2013.04.029. Epub 2013 Jul 21.

Abstract

Background: Allegations of serious failures in infection control practice were made against a dentist practicing in the South West of England. The dentist (who tested negative for Blood Borne Viruses (BBVs)) was immediately suspended.

Methods: Because inadequate infection control presents a potential risk of transmitting BBVs between patients, a notification exercise was undertaken. Of 7625 patients contacted, 2780 (37%) were tested.

Results: Nine cases of Hepatitis B (HBV) and four cases of Hepatitis C (HCV) were identified, of which seven were previously diagnosed. None of these were children. All of the six newly diagnosed cases had recognized risk factors for BBVs. The costs of the notification exercise were estimated at £311,500 of which £165,000 was staff costs, (£51,916 per newly diagnosed case).

Conclusion: This study did not demonstrate any patient-to-patient transmission of blood-borne viruses but the response rate was relatively low. There are significant costs associated with undertaking notification exercises. These findings should inform future recommendations and practice in this area.

Keywords: BBV; Blood borne viruses; Economic evaluation; Look back; Notification exercise.

MeSH terms

  • Blood-Borne Pathogens
  • Contact Tracing / economics
  • Cost-Benefit Analysis
  • Cross Infection / transmission*
  • Disease Notification / economics*
  • England
  • Hepatitis B / transmission*
  • Hepatitis C / transmission*
  • Humans
  • Infection Control, Dental / standards*
  • Mass Screening / economics
  • Risk Factors
  • State Dentistry / economics