Cost of hepatitis B prevention in hospital employees: pre-exposure immunization.

A cost-effectiveness analysis of alternative strategies to prevent hepatitis B in hospital workers was developed to compare pre-exposure immunization with post-exposure prophylaxis. The analysis included the impacts of hepatitis B incidence, employee turnover, strategy efficacy, and medical care expenses to determine the economic effectiveness of immunization and prophylaxis for employees at different risks for hepatitis B exposure. The prophylaxis strategy was found to cost $322 per high-risk employee for a five-year period, while the immunization strategy was found to cost $263 per high-risk employee for a five-year period, for a saving of $59 per employee. Sensitivity analysis demonstrated that pre-exposure immunization remained a cost-effective alternative to post-exposure prophylaxis over a wide range of different model assumptions.

The hepatitis B vaccine: utilization decision process and outcomes in community hospitals.

The process by which administrators, physicians, and other health professionals develop decisions on the adoption of innovations was examined through a study of the decision process relating to the institutional use of a vaccine to prevent hepatitis B. Mail questionnaires and telephone follow-up interviews were used to collect data on the decision process in 56 Arizona hospitals in 1983 and 1984. A five-stage decision process was employed by the institutions. Critical stages in the process involved defining who would make the adoption decision and the collection of information related to the innovation. The institutional plans for vaccine distribution did not exhibit a clear consensus regarding the identification of high-risk employee groups. Employee acceptance of the vaccine, even with the cost paid by the hospital, was limited.