DOI QR코드

DOI QR Code

Workplace influenza vaccination in private hospital setting: a cost-benefit analysis

  • Mohd. Ab. Hadi Tohiar (Department of Community Medicine, Business of Administration Healthcare Management, School of Medicine, International Medical University Malaysia) ;
  • Safurah Jaafar (Department of Community Medicine, Business of Administration Healthcare Management, School of Medicine, International Medical University Malaysia) ;
  • Azimatun Noor Aizuddin (Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia) ;
  • Tan Kok Leong (Department of Community Medicine, School of Medicine, International Medical University Malaysia) ;
  • Azrin Syahida Abdul Rahim (Department of Community Medicine, Business of Administration Healthcare Management, School of Medicine, International Medical University Malaysia)
  • Received : 2021.07.18
  • Accepted : 2021.12.13
  • Published : 2022.12.31

Abstract

Background: Influenza illness causes several disruptions to the workforce. The absenteeism that often ensues has economic implications for employers. This study aimed to estimate the cost-benefit of influenza vaccination in a healthcare setting from the employer's perspective. Methods: A cross-sectional questionnaire survey was conducted in a private hospital in 2018-2019 comparing voluntary vaccinated with non-vaccinated employees with influenza vaccine. The analyses were made based on self-reporting on absenteeism and presenteeism from Influenza-like illnesses (ILIs). The costs incurred, both direct and indirect costs, were included in the study. A cost-benefit analysis was performed by measuring the cost of the vaccination program. The costs of absenteeism and reduced productivity were calculated using 3 hypothesised levels of effectiveness in the following percentage of productivity of 30%, 50%, and 70%. The costs were also calculated based on four scenarios: with and without operating income and with and without replacement. The benefits of the influenza vaccination from the employer's perspective were analysed. The benefit to cost ratio was determined. Results: A total of four hundred and twenty-one respondents participated. The influenza vaccination rate was 63.0%. The rate of ILI of 38.1% was significantly lower among vaccinated. The ILI-related absenteeism reported was also significantly lower amongst vaccinated employees at 30% compared to 70% non-vaccinated. Employers could save up to USD 18.95 per vaccinated employee when only labour cost was included or 54.0% of cost savings. The cost-saving rose to USD 155.56 when the operating income per employee was also included. The benefit to cost ratio confirmed that the net cost-benefit gained from the vaccination was more than the net cost of vaccination. Conclusions: Influenza vaccination for working adults was cost-saving and cost-beneficial when translated into financial investments for the employer. A workplace vaccination demonstrates a significant cost-benefit strategy to be applied in any institutional setting.

Keywords

Acknowledgement

This study was funded by the International Medical University grant reference number: MBAHM I/2019(03).

References

  1. Grohskopf LA, Alyanak E, Broder KR, Walter EB, Fry AM, Jernigan DB. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunisation Practices-United States, 2019-20 influenza season. MMWR Recomm Rep 2019;68(3):1-21.
  2. Nichol KL, Lind A, Margolis KL, Murdoch M, McFadden R, Hauge M, et al. The effectiveness of vaccination against influenza in healthy, working adults. N Engl J Med 1995;333(14):889-93.
  3. Barry JM. The Great Influenza: the Epic Story of the Deadliest Plague in History. London: Penguin Books; 2005.
  4. Pereira M, Williams S, Restrick L, Cullinan P, Hopkinson NSLondon Respiratory Network. Healthcare worker influenza vaccination and sickness absence - an ecological study. Clin Med (Lond) 2017;17(6):484-9.
  5. Rolfes MA, Foppa IM, Garg S, Flannery B, Brammer L, Singleton JA, et al. Annual estimates of the burden of seasonal influenza in the United States: a tool for strengthening influenza surveillance and preparedness. Influenza Other Respi Viruses 2018;12(1):132-7.
  6. Morales A, Martinez MM, Tasset-Tisseau A, Rey E, Baron-Papillon F, Follet A. Costs and benefits of influenza vaccination and work productivity in a Colombian company from the employer's perspective. Value Health 2004;7(4):433-41.
  7. Colamesta V, Tamburrano A, Barbara A, Gentili A, La Milia DI, Berloco F, et al. Cost-consequence analysis of influenza vaccination among the staff of a large teaching hospital in Rome, Italy: a pilot study. PLoS One 2019;14(11):e0225326.
  8. Samad AH, Usul MH, Zakaria D, Ismail R, Tasset-Tisseau A, Baron-Papillon F, et al. Workplace vaccination against influenza in Malaysia: does the employer benefit? J Occup Health 2006;48(1):1-10.
  9. Parlevliet W, de Borgie C, Frijstein G, Guchelaar HJ. Cost-benefit analysis of vaccination against influenza of employees from an academic medical centre. Dis Manag Health Outcomes 2002;10(9):579-87.
  10. Colombo GL, Ferro A, Vinci M, Zordan M, Serra G. Cost-benefit analysis of influenza vaccination in a public healthcare unit. Ther Clin Risk Manag 2006;2(2):219-26.
  11. Yue M, Dickens BL, Yoong JS, I-Cheng Chen M, Teerawattananon Y, Cook AR. Cost-effectiveness analysis for influenza vaccination coverage and timing in tropical and subtropical climate settings: a modeling study. Value Health 2019;22(12):1345-54.
  12. O'Reilly FW, Stevens AB. Sickness absence due to influenza. Occup Med (Lond) 2002;52(5):265-9.
  13. Burckel E, Ashraf T, de Sousa Filho JP, Forleo Neto E, Guarino H, Yauti C, et al. Economic impact of providing workplace influenza vaccination. A model and case study application at a Brazilian pharma-chemical company. Pharmacoeconomics 1999;16(5 Pt 2):563-76.
  14. United Nations, Department of Economic and Social Affairs Population. 2020. https://sdgs.un.org/goals/goal8. Accessed November 20, 2020.
  15. United Nations, Department of Economic and Social Affairs. Goal 8: Promote Sustained, Inclusive and Sustainable Economic Growth, Full and Productive Employment and Decent Work for All. New York, NY, USA: United Nations Statistics Division; 2019.
  16. International Monetary Fund (IMF). World Economic Outlook Reports. Washington, D.C., USA: IMF; 2019.
  17. Stewart WF, Ricci JA, Chee E, Morganstein D. Lost productive work time costs from health conditions in the United States: results from the American Productivity Audit. J Occup Environ Med 2003;45(12):1234-46.
  18. Van Wormer JJ, King JP, Gajewski A, McLean HQ, Belongia EA. Influenza and workplace productivity loss in working adults. J Occup Environ Med 2017;59(12):1135-9.
  19. Zaffina S, Gilardi F, Rizzo C, Sannino S, Brugaletta R, Santoro A, et al. Seasonal influenza vaccination and absenteeism in health-care workers in two subsequent influenza seasons (2016/17 and 2017/18) in an Italian pediatric hospital. Expert Rev Vaccines 2019;18(4):411-8.
  20. Groenewold MR, Burrer SL, Ahmed F, Uzicanin A, Luckhaupt SE. Health-related workplace absenteeism among full-time workers-United States, 2017-18 influenza season. MMWR Morb Mortal Wkly Rep 2019;68(26):577-82.
  21. Aronsson G, Gustafsson K, Dallner M. Sick but yet at work. An empirical study of sickness presenteeism. J Epidemiol Community Health 2000;54(7):502-9.
  22. Bergstrom G, Bodin L, Hagberg J, Aronsson G, Josephson M. Sickness presenteeism today, sickness absenteeism tomorrow? A prospective study on sickness presenteeism and future sickness absenteeism. J Occup Environ Med 2009;51(6):629-38.
  23. Mantel C, Chu SY, Hyde TB, Lambach PIPIE Pilot Implementation Group. Seasonal influenza vaccination in middle-income countries: assessment of immunization practices in Belarus, Morocco, and Thailand. Vaccine 2020;38(2):212-9.
  24. McKevitt C, Morgan M, Dundas R, Holland WW. Sickness absence and 'working through' illness: a comparison of two professional groups. J Public Health Med 1997;19(3):295-300.
  25. Bloom DE, Brenzel L, Cadarette D, Sullivan J. Moving beyond traditional valuation of vaccination: needs and opportunities. Vaccine 2017;35 Suppl 1:A29-35.
  26. Preaud E, Durand L, Macabeo B, Farkas N, Sloesen B, Palache A, et al. Annual public health and economic benefits of seasonal influenza vaccination: a European estimate. BMC Public Health 2014.14:813.
  27. Currency Converter. 2021. USD MYR historical exchange rate. https://www.currency-converter.org.uk/currency-rates/historical/table/USD-MYR.html. Accessed December 15, 2020.
  28. Keech M, Scott AJ, Ryan PJ. The impact of influenza and influenza-like illness on productivity and healthcare resource utilization in a working population. Occup Med (Lond) 1998;48(2):85-90.
  29. Nichol KL. Cost-benefit analysis of a strategy to vaccinate healthy working adults against influenza. Arch Intern Med 2001;161(5):749-59.
  30. Costantino C, Vitale F. Influenza vaccination in high-risk groups: a revision of existing guidelines and rationale for an evidence-based preventive strategy. J Prev Med Hyg 2016;57(1):E13-8.
  31. At'kov OY, Azarov AV, Zhukov DA, Nicoloyannis N, Durand L. Influenza vaccination in healthy working adults in Russia: observational study of effectiveness and return on investment for the employer. Appl Health Econ Health Policy 2011;9(2):89-99.
  32. Ferro A, Bordin P, Benacchio L, Fornasiero F, Bressan V, Tralli V, et al. Influenza vaccination and absenteeism among healthy working adults: a cost-benefit analysis. Ann Ig 2020;32(3):234-44.