Recent estimates put the cost of MRSA infections in US hospitals between $3.2 billion and $4.2 billion each year1. Individual costs associated with treating an MRSA or S. aureus infection range from a few thousand dollars for minor cases up to well over $100,000 for complicated post-surgical infections.2 With these numbers, you would think its a no-brainer for hospitals to institute rigorous MRSA control procedures to keep the infection rate at a minimum. The problem is that there are costs associated with adopting MRSA surveillance and treatment procedures. Thus, and especially in a largely privatized healthcare environment such as the US, it unfortunately comes down to the issue of return on investment. Put simply: do the costs saved by preventing “x” number of infections justify the expenditures necessary to carry out the prevention program?
As mentioned in previous posts, there is a growing body of scientific literature suggesting that preventative measures aimed at identifying and decolonizing MRSA carriers are effective in reducing hospital infection rates. Several studies conducted in the US and abroad have also attempted to determine whether MRSA screening and decolonization actually prevent enough infections to be economically feasible. A recent study of this kind, published in the November 2010 issue of the Journal of Infection Control and Hospital Epidemiology, used complex modeling to evaluate whether MRSA screening and decolonization of pre-operative orthopedic surgery patients had a positive economic value.3
The study described above was conducted at the University of Pittsburgh in collaboration with the Division of Infectious Diseases at the Veterans Affairs (VA) Pittsburgh Health System. In an effort to estimate the value of implementing a universal presurgical MRSA screening and decolonization program, investigators built predictive models around three key parameters:
- MRSA colonization rates among patients (1%-30%)
- Decolonization success rates (25%-100%)
- Decolonization costs ($100 – $300)
In majority of the scenarios examined, a universal presurgical MRSA surveillance program for orthopedic patients was considered an economically dominant strategy (more effective and less expensive). Even in the worst case scenarios of lowest colonization rates, lowest decolonization success rates, and highest costs, universal MRSA screening and decolonization was still considered strongly cost-effective compared to the cost of treating MRSA infections. To summarize, in the majority of scenarios modeled the costs savings associated with reduced infection rate exceeded the cost of implementing the screening and decolonization program.
This study is important in that it is the latest to support the economic considerations of implementing a presurgical MRSA screening and decolonization program in the hospital setting. In today’s healthcare environment of limited resources and funding, answering this question is equally as important as the initial work to determine whether screening and decolonization interventions actually reduce MRSA infection rate.
The abstract and full study can be downloaded at: http://www.ncbi.nlm.nih.gov/pubmed/20923285
Special thanks to Clarence Chew for contribution to this post.
1 New Research Estimates MRSA Infections Cost U.S. Hospitals $3.2 Billion to $4.2 Billion Annually.” Summary of poster session (Abstract ID#9489) presented by the U.S. Outcomes Research Group of Pfizer Inc. at the International Society for Pharmacoeconomics and Outcomes Research. 2005 May
2 Noskin GA et al. (2005) Archives of Internal Medicine 165: 1756-1761
3 Lee BY et al. (2010) Infection Control and Hospital Epidemiology 31:1130–1138