Cost of screening intensive care unit patients for methicillin-resistant Staphylococcus aureus in hospitals

• Published in: American journal of infection control 2011-02, Vol.39 (1), p.27-34
• Main Authors: Nyman, John A., PhD, Lees, Christine H., MPH, RN, Bockstedt, Lindsay A., PhD, Filice, Gregory A., MD, Lexau, Catherine, PhD, MPH, Lesher, Lindsey J., MPH, Como-Sabetti, Kathryn, MPH, Lynfield, Ruth, MD
• Format: Article
• Language: English
• Subjects: Bacterial diseases; Bacteriological Techniques - economics; Biological and medical sciences; Carrier State - diagnosis; Cost reduction; costs; Epidemiology. Vaccinations; General aspects; Hospital costs; Hospitals; Human bacterial diseases; Humans; Infection Control; Infectious Disease; Infectious diseases; Intensive care; Intensive Care Units; Mass Screening - economics; Medical sciences; Medical screening; Medical treatment; Methicillin-resistant Staphylococcus aureus; Methicillin-Resistant Staphylococcus aureus - isolation & purification; MRSA; Patient admissions; screening; Staphylococcal Infections - diagnosis; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcus infections
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2010.09.006

Background The objective of this study is to determine the costs per hospital admission of screening intensive care unit patients for methicillin-resistant Staphylococcus aureus (MRSA) and isolating those who are colonized. Methods Data on the costs of the intervention come from the Minneapolis Veterans Affairs Medical Center, a 279-bed teaching hospital and outpatient facility. A microcosting approach is used to determine the intervention costs for 3 different laboratory testing protocols. The costs of caring for MRSA-infected patients come from the experience of 241 Minneapolis Veterans Affairs Medical Center patients with MRSA infections in 2004 through 2006. The effectiveness of the intervention comes from the extant literature. To capture the effect of screening on reducing transmission of MRSA to other patients and its effect on costs, a Markov simulation model was employed. Results The intervention was cost saving compared with no intervention for all 3 laboratory processes evaluated and for all of the 1-way sensitivity analyses considered. Conclusion Because of the high cost of caring for a MRSA patient, interventions that reduce the spread of infections—such as screening intensive care unit patients upon admission studied here—are likely to pay for themselves.