We analyze hand hygiene (HH) compliance, incidence of hospital-acquired infection, and cost-effectiveness after applying a HH program in intensive care units in a large tertiary Vietnamese hospital.

After hand hygiene (HH) program intervention, the HH compliance rate increased from 25.7% to 57.5% (P < .001), and the incidence of patients with hospital-acquired infection decreased by 36%, from 31.7% to 20.3% (P < .001).

The mean cost for patients with hospital-acquired infection (HAI) was $1,908, which was 2.5 times higher than the costs for patients without an HAI; the mean attributable cost of an HAI was $1,131.

Cost-effectiveness was estimated at $1,074 saved per hospital-acquired infection prevented.

The hand hygiene (HH) program is an effective strategy in reducing the incidence of hospital-acquired infections and is cost-effective in Vietnam; HH programs need to be encouraged across Vietnam and other low- and middle-income countries.