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Economic burden of universal MRSA screening could be too costly for hospitals
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Despite calls by experts and policymakers for hospitals to screen patients for MRSA infections and isolate those posing high risk, and laws in several states that require testing on admission, the economic burden may be too much for hospitals to bear, researchers found.
“Prior research has shown that expanded MRSA screening would prevent infections, save lives and reduce costs for the entire healthcare system,” James A. McKinnell, MD, an infectious disease specialist at the Los Angeles Biomedical Research Institute, told Infectious Disease News.
“Our research confirms that expanded surveillance can save lives but that such a program would be too expensive for an individual hospital to launch,” he said. “Ultimately, hospitals cannot be expected to launch larger, more effective programs, when doing so would threaten the sustainability of the hospital.”
James A. McKinnell
McKinnell and colleagues conducted two separate studies modeling the direct economic impact of expanding surveillance in an individual hospital. For both investigations, the researchers projected costs and benefits based on literature-derived data.
The first model examined the impact of expanding MRSA surveillance with more advanced testing techniques and more aggressive sampling procedures. The researchers determined that using the traditional method of testing for MRSA prevented three MRSA infections, but resulted in the hospital losing $103,000 (95% CI, $83,000-$126,000) for every 10,000 hospital admissions. More extensive screening prevented more infections but increased the cost.
The second model examined the impact of limiting the program to patients at high risk for MRSA. Limiting the program to high-risk patients improved the benefit, to prevent six infections, but resulted in a $368,990 financial loss for the hospital per 10,000 admissions.
Surveillance of three body-sites for high-risk patients resulted in an even greater financial loss of $514,780. A strategy of presumptively isolating patients was most effective, preventing 10 infections, and also the most costly, at $3,007,650 per 10,000 admissions.
“Infection prevention is a life-saving component of medical care and can ultimately save millions of dollars in health care costs,” McKinnell said. “The fundamental problem is that all of the costs of infection prevention are carried by hospitals, but all of the benefits go to insurance companies.”
Until hospitals are paid for additional infection prevention work, McKinnell said it is unlikely the community would see expansion of life-saving and cost-effective infection prevention strategies. “We recommend consideration of specific financial incentives to hospitals to support infection prevention,” McKinnell said. – by Allegra Tiver
For more information:
McKinnell JA, et al. Abstracts 892 and 901. Presented at: ID Week; Oct 8-12, 2014, Philadelphia.
Disclosure: McKinnell reports no relevant financial disclosures.