title: Cost-benefit and effectiveness analysis of rapid testing for MRSA carriage in a hospital setting.
abstract: 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.
authors.forename: Gay
authors.initials: G
authors.lastname: Henson
authors.forename: Elham
authors.initials: E
authors.lastname: Ghonim
authors.forename: Andrea
authors.initials: A
authors.lastname: Swiatlo
authors.forename: Shelia
authors.initials: S
authors.lastname: King
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Moore
authors.forename: S Travis
authors.initials: ST
authors.lastname: King
authors.forename: Donna
authors.initials: D
authors.lastname: Sullivan
mesh_terms: D002353:Carrier State / Q000175:diagnosis*; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000175:diagnosis*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007902:Length of Stay; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D010865:Pilot Projects; D016133:Polymerase Chain Reaction / Q000191:economics; D013997:Time Factors