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Table 6 Costs related to a companion animal colonized or infected with a resistant pathogen (using its owner as proxy), necessary in a “One-Health” cost model

From: A one health framework to estimate the cost of antimicrobial resistance

Data element Category of costs Individual costs
Direct Costs of any treatment of the animal borne by the veterinary service (regardless of whether or not such costs are passed on to an insurance company. − Cost of antibiotics
− Cost of drug administration (central lines, etc)
− Costs of diagnostic tests
− Cost of nursing care
− Cost of cohorting (including cost of leaving not occupied beds due to isolation of one patient restricting the use of the bed(s) in the same room)
− Extended length of stay
− Cost of non-standard surgical prophylaxis. Surgical prophylaxis in infected patients, with more expensive drugs
− Extra hospital admissions, or extra care required for disease sequelae directly linked to the drug-resistant infection, like recurrent infection, kidney failure, amputation, neurological sequelae, extra surgery
  Out-of-pocket expenditure borne by the owner for care − travel or transport to and from the veterinary clinic
− special food, physiotherapy, transport
− referring to specialists of complex cases
− pet health insurance
− Cost of disposal of remains/incineration/funeral
  Surveillance and control activities − Costs of enhanced surveillance
− Cost of any screening that is triggered
− Costs of isolation, cohorting or contact precautions to the veterinary health care system
− Costs for environmental decontamination of MDR bacteria
  Training of health care professionals and information/communication − Costs of pre-service, in-service and continuous professional education per relevant cadre of veterinary healthcare professional
− Cost of any related public health or information campaign
  Legal and insurance costs (patient) − Additional insurance costs to cover problems associated specifically with resistance
− Litigation costs, when suing hospitals for transmission of resistance infection
  Legal and insurance costs (hospital) − Litigation costs, when sued by patients for transmission of resistance infection
− Costs of implementing or regulating and enforcing national robust, representative comprehensive surveillance programmes among companion animals
Indirect Loss of owner productivity when seeking treatment for the animal’s resistant infection (or colonisation) or when the animal dies from the resistant infection − value of foregone workdays