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Ebola in the Netherlands, 2014–2015: costs of preparedness and response

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Abstract

The recent epidemic of Ebola virus disease (EVD) resulted in countries worldwide to prepare for the possibility of having an EVD patient. In this study, we estimate the costs of Ebola preparedness and response borne by the Dutch health system. An activity-based costing method was used, in which the cost of staff time spent in preparedness and response activities was calculated based on a time-recording system and interviews with key professionals at the healthcare organizations involved. In addition, the organizations provided cost information on patient days of hospitalization, laboratory tests, personal protective equipment (PPE), as well as the additional cleaning and disinfection required. The estimated total costs averaged €12.6 million, ranging from €6.7 to €22.5 million. The main cost drivers were PPE expenditures and preparedness activities of personnel, especially those associated with ambulance services and hospitals. There were 13 possible cases clinically evaluated and one confirmed case admitted to hospital. The estimated total cost of EVD preparedness and response in the Netherlands was substantial. Future costs might be reduced and efficiency increased by designating one ambulance service for transportation and fewer hospitals for the assessment of possible patients with a highly infectious disease of high consequences.

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Acknowledgements

We would like to thank the following organizations and professionals for their contribution to the study: Erasmus Medical Center, Leiden University Medical Center, Radboud University Medical Center, VU University Medical Center, Major Incident Hospital/University Medical Center Utrecht, Isala Hospital, Rijnstate Hospital, Spaarne Hospital, Department of Virology of the Erasmus Medical Center, GGD Hart voor Brabant, GGD Amsterdam, GGD Rotterdam Rijnmond, GGD Noord- en Oost-Gelderland, GGD Gelderland-Midden, GGD regio Utrecht, GGD Hollands Midden, RAV Kennemerland, RAV Hollands Midden, RAV Gelderland Midden, RAV Zuid-Holland Zuid, RAV Amsterdam-Amstelland, RAV IJsselland, RAV Gelderland Zuid, RAV Brabant-Zuidoost, AZN, Lucy Phillips for editing the manuscript, Mariska Zwiggelaar from NZA, and André Jacobi, Lizzy Slok, Anna Lugnér, Esmee Wardenaar, and Hogaei Oriakheil, working at RIVM.

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Authors and Affiliations

  1. National Institute for Public Health and the Environment, RIVM, PO Box 1, 3720 BA, Bilthoven, The Netherlands

    Anita W. M. Suijkerbuijk, Corien M. Swaan, Marie-Josee J. Mangen, Johan J. Polder, Aura Timen & Wilhelmina L. M. Ruijs

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  1. Anita W. M. Suijkerbuijk
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  2. Corien M. Swaan
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  3. Marie-Josee J. Mangen
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Correspondence to Anita W. M. Suijkerbuijk.

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Suijkerbuijk, A.W.M., Swaan, C.M., Mangen, MJ.J. et al. Ebola in the Netherlands, 2014–2015: costs of preparedness and response. Eur J Health Econ 19, 935–943 (2018). https://doi.org/10.1007/s10198-017-0940-4

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