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Modelling the costs and effects of selective and universal hospital admission screening for methicillin-resistant Staphylococcus aureus
- Source :
- PLoS ONE, Vol 6, Iss 3, p e14783 (2011), PLoS ONE, PLoS ONE, 6(3):14783. PUBLIC LIBRARY SCIENCE
- Publication Year :
- 2011
- Publisher :
- Public Library of Science (PLoS), 2011.
-
Abstract
- Background: Screening at hospital admission for carriage of methicillin-resistant Staphylococcus aureus (MRSA) has been proposed as a strategy to reduce nosocomial infections. The objective of this study was to determine the long-term costs and health benefits of selective and universal screening for MRSA at hospital admission, using both PCR-based and chromogenic media-based tests in various settings.Methodology/Principal Findings: A simulation model of MRSA transmission was used to determine costs and effects over 15 years from a US healthcare perspective. We compared admission screening together with isolation of identified carriers against a baseline policy without screening or isolation. Strategies included selective screening of high risk patients or universal admission screening, with PCR-based or chromogenic media-based tests, in medium (5%) or high nosocomial prevalence (15%) settings. The costs of screening and isolation per averted MRSA infection were lowest using selective chromogenic-based screening in high and medium prevalence settings, at $4,100 and $10,300, respectively. Replacing the chromogenic-based test with a PCR-based test costs $13,000 and $36,200 per additional infection averted, and subsequent extension to universal screening with PCR would cost $131,000 and $232,700 per additional infection averted, in high and medium prevalence settings respectively. Assuming $17,645 benefit per infection averted, the most cost-saving strategies in high and medium prevalence settings were selective screening with PCR and selective screening with chromogenic, respectively.Conclusions/ Significance: Admission screening costs $4,100-$21,200 per infection averted, depending on strategy and setting. Including financial benefits from averted infections, screening could well be cost saving.
- Subjects :
- Methicillin-Resistant Staphylococcus aureus
Infectious Diseases/Epidemiology and Control of Infectious Diseases
medicine.medical_specialty
INTENSIVE-CARE-UNIT
Isolation (health care)
IMPACT
TRANSMISSION
INFECTION-CONTROL
lcsh:Medicine
MRSA
Public Health and Epidemiology/Health Policy
medicine.disease_cause
Staphylococcal infections
law.invention
Public Health and Epidemiology/Nosocomial and Healthcare-Associated Infections
Infectious Diseases/Bacterial Infections
Patient Admission
Evidence-Based Healthcare/Health Services Research and Economics
law
Public Health and Epidemiology/Health Services Research and Economics
SURVEILLANCE
medicine
Infection control
Humans
Mass Screening
Intensive care medicine
lcsh:Science
Mass screening
health care economics and organizations
Multidisciplinary
business.industry
lcsh:R
Cost-effectiveness analysis
Staphylococcal Infections
medicine.disease
Intensive care unit
Methicillin-resistant Staphylococcus aureus
PREVALENCE
Carriage
STATES
Emergency medicine
RISK-FACTORS
lcsh:Q
SPREAD
business
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 6
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....ce33f257bc1469552acca5128fade05d