Cost Savings of Universal Decolonization to Prevent Intensive Care Unit Infection: Implications of the REDUCE MRSA Trial
| Autor: | Grace M. Lee, Julia Moody, Robert A. Weinstein, Richard Platt, G. Thomas Ray, Edward Septimus, Mary K. Hayden, Jonathan B. Perlin, Susan S. Huang, Jason Hickok, Taliser R. Avery |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
0301 basic medicine
bacterial colonization Epidemiology polymerase chain reaction Bacteremia medicine.disease_cause intensive care unit Medical and Health Sciences law.invention 0302 clinical medicine Randomized controlled trial law Health care pseudomonic acid Mass Screening 030212 general & internal medicine Hospital Costs Cross Infection chlorhexidine health care cost Staphylococcal Infections simulation Intensive care unit Cost savings Intensive Care Units Infectious Diseases Carrier State hospital infection Nasal Cavity Decolonization Adult Methicillin-Resistant Staphylococcus aureus Microbiology (medical) medicine.medical_specialty Icu patients Isolation (health care) 030106 microbiology bloodstream infection Article 03 medical and health sciences Cost Savings bacterium isolation medicine Humans human Intensive care medicine decision analysis model cost control health care system business.industry Length of Stay Methicillin-resistant Staphylococcus aureus hospital admission randomized controlled trial methicillin resistant Staphylococcus aureus infection business mathematical model |
| Zdroj: | Huang, SS; Septimus, E; Avery, TR; Lee, GM; Hickok, J; Weinstein, RA; et al.(2014). Cost savings of universal decolonization to prevent intensive care unit infection: Implications of the REDUCE MRSA trial. Infection Control and Hospital Epidemiology, 35, S23-S31. doi: 10.1086/677819. UC Irvine: Retrieved from: http://www.escholarship.org/uc/item/43g0531q Infection control and hospital epidemiology, vol 35 Suppl 3, iss S3 |
| ISSN: | 1559-6834 0899-823X |
| Popis: | Objective.To estimate and compare the impact on healthcare costs of 3 alternative strategies for reducing bloodstream infections in the intensive care unit (ICU): methicillin-resistant Staphylococcus aureus (MRSA) nares screening and isolation, targeted decolonization (ie, screening, isolation, and decolonization of MRSA carriers or infections), and universal decolonization (ie, no screening and decolonization of all ICU patients).Design.Cost analysis using decision modeling.Methods.We developed a decision-analysis model to estimate the health care costs of targeted decolonization and universal decolonization strategies compared with a strategy of MRSA nares screening and isolation. Effectiveness estimates were derived from a recent randomized trial of the 3 strategies, and cost estimates were derived from the literature.Results.In the base case, universal decolonization was the dominant strategy and was estimated to have both lower intervention costs and lower total ICU costs than either screening and isolation or targeted decolonization. Compared with screening and isolation, universal decolonization was estimated to save $171,000 and prevent 9 additional bloodstream infections for every 1,000 ICU admissions. The dominance of universal decolonization persisted under a wide range of cost and effectiveness assumptions.Conclusions.A strategy of universal decolonization for patients admitted to the ICU would both reduce bloodstream infections and likely reduce healthcare costs compared with strategies of MRSA nares screening and isolation or screening and isolation coupled with targeted decolonization. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|