PMID- 30858309
OWN - NLM
STAT- MEDLINE
DCOM- 20190520
LR  - 20190912
IS  - 1091-6490 (Electronic)
IS  - 0027-8424 (Linking)
VI  - 116
IP  - 13
DP  - 2019 Mar 26
TI  - Incentivizing hospital infection control.
PG  - 6221-6225
LID - 10.1073/pnas.1812231116 [doi]
AB  - Healthcare-associated infections (HAIs) pose a significant burden to patient
      safety. Institutions can implement hospital infection control (HIC) measures to
      reduce the impact of HAIs. Since patients can carry pathogens between
      institutions, there is an economic incentive for hospitals to free ride on the
      HIC investments of other facilities. Subsidies for infection control by public
      health authorities could encourage regional spending on HIC. We develop coupled
      mathematical models of epidemiology and hospital behavior in a game-theoretic
      framework to investigate how hospitals may change spending behavior in response
      to subsidies. We demonstrate that under a limited budget, a dollar-for-dollar
      matching grant outperforms both a fixed-amount subsidy and a subsidy on
      uninfected patients in reducing the number of HAIs in a single institution.
      Additionally, when multiple hospitals serve a community, funding priority should 
      go to the hospital with a lower transmission rate. Overall, subsidies incentivize
      HIC spending and reduce the overall prevalence of HAIs.
CI  - Copyright (c) 2019 the Author(s). Published by PNAS.
FAU - Drohan, Sarah E
AU  - Drohan SE
AUID- ORCID: 0000-0001-9789-2815
AD  - Program in Applied and Computational Mathematics, Princeton University,
      Princeton, NJ 08544; sedrohan@princeton.edu slevin@princeton.edu
      ramanan@cddep.org.
FAU - Levin, Simon A
AU  - Levin SA
AD  - Program in Applied and Computational Mathematics, Princeton University,
      Princeton, NJ 08544; sedrohan@princeton.edu slevin@princeton.edu
      ramanan@cddep.org.
AD  - Department of Ecology and Evolutionary Biology, Princeton University, Princeton, 
      NJ 08544.
AD  - Princeton Environmental Institute, Princeton University, Princeton, NJ 08544.
FAU - Grenfell, Bryan T
AU  - Grenfell BT
AD  - Department of Ecology and Evolutionary Biology, Princeton University, Princeton, 
      NJ 08544.
AD  - Fogarty International Center, National Institutes of Health, Bethesda, MD 20892.
FAU - Laxminarayan, Ramanan
AU  - Laxminarayan R
AUID- ORCID: 0000-0002-1390-9016
AD  - Princeton Environmental Institute, Princeton University, Princeton, NJ 08544;
      sedrohan@princeton.edu slevin@princeton.edu ramanan@cddep.org.
AD  - Center for Disease Dynamics, Economics & Policy, Washington, DC 20036.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20190311
PL  - United States
TA  - Proc Natl Acad Sci U S A
JT  - Proceedings of the National Academy of Sciences of the United States of America
JID - 7505876
SB  - IM
MH  - Budgets
MH  - Cross Infection/economics/*epidemiology
MH  - Drug Resistance, Microbial
MH  - Economics, Hospital
MH  - *Game Theory
MH  - Hospital Costs
MH  - *Hospitals
MH  - Humans
MH  - *Infection Control
MH  - *Models, Theoretical
MH  - Prevalence
PMC - PMC6442548
OTO - NOTNLM
OT  - *antimicrobial resistance
OT  - *game theory
OT  - *nosocomial infection
OT  - *subsidy
EDAT- 2019/03/13 06:00
MHDA- 2019/05/21 06:00
CRDT- 2019/03/13 06:00
PHST- 2019/03/13 06:00 [pubmed]
PHST- 2019/05/21 06:00 [medline]
PHST- 2019/03/13 06:00 [entrez]
AID - 1812231116 [pii]
AID - 10.1073/pnas.1812231116 [doi]
PST - ppublish
SO  - Proc Natl Acad Sci U S A. 2019 Mar 26;116(13):6221-6225. doi:
      10.1073/pnas.1812231116. Epub 2019 Mar 11.