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Additional costs for preventing the spread of methicillin-resistant Staphylococcus aureus and a strategy for reducing
Caroline Eva Wella Herr1, Thomas Hilarius Heckrodt, Frank Andreas Hofmann
1Institute of Hygiene and Environmental Medicine, Justus-Liebig University of Giessen, Friedrichstrasse 16, D-35385 Giessen, Germany.
Objective:
To determine the added costs of hygienic measures (barrier precautions, isolation, and decontamination) required for MRSA carriers in German hospitals and possible strategies for cost reduction.
Design:
On a septic surgical ward caring for 35% of all MRSA cases in a university hospital (1,182 beds), additional costs for personnel time and materials were calculated and medical charts of all MRSA cases admitted to the ward during 1 year were analyzed retrospectively. Twelve of the ward's 13 beds were located in rooms with at least 2 beds.
Patients:
Four hundred ninety-eight MRSA carrier hospital-days (of 20 MRSA cases) could be assessed. All patients (80% men, 50% older than 74.5 years) had broken skin.
Results:
In 95% of the cases, microbiological findings suggested transmission of MRSA during the current or a previous stay on this ward. The study found total avoidable costs of approximately 142,794.01 euros in 1 year, averaging 371.95 euros for one MRSA patient hospital-day and 9,261.56 euros per MRSA case. The most expensive single measure was blocked beds in multibed rooms (305.75 euros/day), which accounted for 82% of the extra costs. Costs most likely were underestimated.
Conclusions:
Daily additional case costs amounted to 96% of social security payments. Blocked beds in multibed rooms accounted for more than 80% of these excess costs. Isolation has been scientifically validated and is required by law in Germany. Building an adequate number of single-bed rooms should help prevent spread and would greatly lower the added costs of infection.
Insights
High costs for preventing MRSA spread in German hospitals stem from blocked beds in multi-bed rooms. Building more single rooms could significantly reduce these expenses.
Area of Science:
- Infection Control and Hospital Epidemiology
- Healthcare Economics
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant challenge in healthcare settings.
- Hygienic measures are crucial for preventing MRSA transmission but incur additional costs.
Purpose of the Study:
- To quantify the added costs of MRSA carrier management in German hospitals.
- To identify cost-reduction strategies for MRSA prevention.
Main Methods:
- Retrospective analysis of medical charts and costs on a surgical ward over one year.
- Calculation of additional costs for personnel time and materials related to hygienic measures.
Main Results:
- Total avoidable costs approximated €142,794 annually, averaging €371.95 per MRSA patient-day.
- Blocked beds in multi-bed rooms represented 82% of extra costs (€305.75/day).
- MRSA transmission was suggested in 95% of cases during hospital stays.
Conclusions:
- Additional daily costs for MRSA carriers reached 96% of social security payments.
- Multi-bed room blocking is the primary cost driver, highlighting the need for single rooms.
- Implementing adequate single-bed rooms is recommended to reduce MRSA spread and associated costs.
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