PT  - JOURNAL ARTICLE
AU  - Henson, Gay
AU  - Ghonim, Elham
AU  - Swiatlo, Andrea
AU  - King, Shelia
AU  - Moore, Kimberly S.
AU  - King, S. Travis
AU  - Sullivan, Donna
TI  - Cost-benefit and Effectiveness Analysis of Rapid Testing for MRSA Carriage in a Hospital Setting
AID  - 10.29074/ascls.27.1.13
DP  - 2014 Jan 01
TA  - American Society for Clinical Laboratory Science
PG  - 13--20
VI  - 27
IP  - 1
4099  - http://hwmaint.clsjournal.ascls.org/content/27/1/13.short
4100  - http://hwmaint.clsjournal.ascls.org/content/27/1/13.full
SO  - Clin Lab Sci2014 Jan 01; 27
AB  - A cost-effectiveness analysis was conducted comparing the polymerase chain reaction assay and traditional microbiological culture as screening tools for the identification of methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to the pediatric and surgical intensive care units (PICU and SICU) at a 722 bed academic medical center. In addition, the cost benefits of identification of colonized MRSA patients were determined. The cost-effectiveness analysis employed actual hospital and laboratory costs, not patient costs. The actual cost of the PCR assay was higher than the microbiological culture identification of MRSA ($602.95 versus $364.30 per positive carrier identified). However, this did not include the decreased turn-around time of PCR assays compared to traditional culture techniques. Patient costs were determined indirectly in the cost-benefit analysis of clinical outcome. There was a reduction in MRSA hospital-acquired infection (3.5 MRSA HAI/month without screening versus 0.6/month with screening by PCR). A cost-benefit analysis based on differences in length of stay suggests an associated savings in hospitalization costs: MRSA HAI with 29.5 day median LOS at $63,810 versus MRSA identified on admission with 6 day median LOS at $14,561, a difference of $49,249 per hospitalization. Although this pilot study was small and it is not possible to directly relate the cost-effectiveness and cost-benefit analysis due to confounding factors such as patient underlying morbidity and mortality, a reduction of 2.9 MRSA HAI/month associated with PCR screening suggests potential savings in hospitalization costs of $142,822 per month.ABBREVIATIONS: MSSA - methicillin sensitive Staphylococcus aureus; MRSA - methicillin-resistant Staphylococcus aureus; PCR - polymerase chain reaction; HAI - hospital acquired infection; LOS - length of stay