RT Journal Article
SR Electronic
T1 Cost-benefit and Effectiveness Analysis of Rapid Testing for MRSA Carriage in a Hospital Setting
JF American Society for Clinical Laboratory Science
JO Clin Lab Sci
FD American Society of Chemistry and Laboratory Science
SP 13
OP 20
DO 10.29074/ascls.27.1.13
VO 27
IS 1
A1 Henson, Gay
A1 Ghonim, Elham
A1 Swiatlo, Andrea
A1 King, Shelia
A1 Moore, Kimberly S.
A1 King, S. Travis
A1 Sullivan, Donna
YR 2014
UL http://hwmaint.clsjournal.ascls.org/content/27/1/13.abstract
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