The financial impact of controlling a respiratory virus outbreak in a teaching hospital - Lessons learned from SARS

Background: Outbreaks of Severe Acute Respiratory Syndrome (SARS) in 2003 and renewed concerns regarding pandemic influenza have resulted in widespread planning for future respiratory disease outbreaks. Such planning should include accurate cost estimates for any proposed disease control strategies. From the acute care hospital perspective, such estimates typically take into account the cost of supplies and equipment, but rarely consider indirect costs such as lost revenue due to the scaling down of programs. Methods: Retrospective cost analysis. Costs and savings were calculated from the hospital perspective using financial records. Costs were categorized to determine the major areas of expenditure and savings. Results: We report that controlling a SARS outbreak in a teaching hospital over an 8-week period cost $12 million Canadian. Lost revenue and labour accounted for two thirds of the costs incurred while excess spending on services, materials, supplies and renovation of existing space accounted for the remaining one third. Conclusions: Cost estimates that consider only excess expenditures may considerably underestimate the true cost of infection control strategies.