Division of Health Policy and Management, University of Minnesota School of Public Health, 420 Delaware St SE, Minneapolis, MN 55455, USA.
Am J Infect Control. 2011 Feb;39(1):27-34. doi: 10.1016/j.ajic.2010.09.006.
The objective of this study is to determine the costs per hospital admission of screening intensive care unit patients for methicillin-resistant Staphylococcus aureus (MRSA) and isolating those who are colonized.
Data on the costs of the intervention come from the Minneapolis Veterans Affairs Medical Center, a 279-bed teaching hospital and outpatient facility. A microcosting approach is used to determine the intervention costs for 3 different laboratory testing protocols. The costs of caring for MRSA-infected patients come from the experience of 241 Minneapolis Veterans Affairs Medical Center patients with MRSA infections in 2004 through 2006. The effectiveness of the intervention comes from the extant literature. To capture the effect of screening on reducing transmission of MRSA to other patients and its effect on costs, a Markov simulation model was employed.
The intervention was cost saving compared with no intervention for all 3 laboratory processes evaluated and for all of the 1-way sensitivity analyses considered.
Because of the high cost of caring for a MRSA patient, interventions that reduce the spread of infections-such as screening intensive care unit patients upon admission studied here-are likely to pay for themselves.
本研究旨在确定对重症监护病房患者进行耐甲氧西林金黄色葡萄球菌（MRSA）筛查并对定植患者进行隔离的住院费用。
干预措施的成本数据来自明尼苏达州退伍军人事务医疗中心，这是一家拥有 279 张病床的教学医院和门诊设施。采用微观成本法确定 3 种不同实验室检测方案的干预成本。MRSA 感染患者的治疗成本来自于 2004 年至 2006 年期间 241 名明尼苏达州退伍军人事务医疗中心患者的经验。干预效果来自现有文献。为了捕捉筛查对降低 MRSA 向其他患者传播的效果及其对成本的影响，采用了马尔可夫模拟模型。
与不干预相比，所有 3 种实验室检测过程和所有考虑的单向敏感性分析均显示干预具有成本效益。
由于 MRSA 患者的治疗费用高昂，因此减少感染传播的干预措施（如本研究中对重症监护病房患者进行入院筛查）很可能会自行支付成本。
