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Economic Analysis of Veterans Affairs Initiative to Prevent Methicillin-Resistant Staphylococcus aureus Infections
Richard E Nelson1, Vanessa W Stevens2, Karim Khader1
1Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah; Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah.
Introduction:
In an effort to reduce methicillin-resistant Staphylococcus aureus (MRSA) transmission through universal screening and isolation, the Department of Veterans Affairs (VA) launched the National MRSA Prevention Initiative in October 2007. The objective of this analysis was to quantify the budget impact and cost effectiveness of this initiative.
Methods:
An economic model was developed using published data on MRSA hospital-acquired infection (HAI) rates in the VA from October 2007 to September 2010; estimates of the costs of MRSA HAIs in the VA; and estimates of the intervention costs, including salaries of staff members hired to support the initiative at each VA facility. To estimate the rate of MRSA HAIs that would have occurred if the initiative had not been implemented, two different assumptions were made: no change and a downward temporal trend. Effectiveness was measured in life-years gained.
Results:
The initiative resulted in an estimated 1,466-2,176 fewer MRSA HAIs. The initiative itself was estimated to cost $207 million during this 3-year period, while the cost savings from prevented MRSA HAIs ranged from $27 million to $75 million. The incremental cost-effectiveness ratios ranged from $28,048 to $56,944/life-years. The overall impact on the VA's budget was $131-$179 million.
Conclusions:
Wide-scale implementation of a national MRSA surveillance and prevention strategy in VA inpatient settings may have prevented a substantial number of MRSA HAIs. Although the savings associated with prevented infections helped offset some but not all of the cost of the initiative, this model indicated that the initiative would be considered cost effective.
Insights
The Department of Veterans Affairs
Area of Science:
- Healthcare Economics
- Infectious Disease Prevention
- Public Health Policy
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings.
- The Department of Veterans Affairs (VA) implemented a national strategy to combat MRSA transmission.
- Understanding the economic impact of such initiatives is crucial for resource allocation.
Purpose of the Study:
- To quantify the budget impact of the VA's National MRSA Prevention Initiative.
- To assess the cost-effectiveness of the national MRSA prevention strategy.
- To evaluate the financial implications of reducing MRSA hospital-acquired infections (HAIs).
Main Methods:
- Developed an economic model using VA data from October 2007 to September 2010.
- Estimated MRSA HAI rates with and without the initiative.
- Calculated intervention costs and cost savings from prevented infections.
- Measured effectiveness in life-years gained.
Main Results:
- The initiative potentially prevented 1,466-2,176 MRSA HAIs.
- The initiative cost an estimated $207 million over three years.
- Cost savings from prevented infections ranged from $27 million to $75 million.
- The overall budget impact was $131-$179 million, with incremental cost-effectiveness ratios between $28,048 and $56,944 per life-year gained.
Conclusions:
- A national MRSA surveillance and prevention strategy can significantly reduce MRSA HAIs in inpatient settings.
- While not fully cost-neutral, the initiative demonstrated cost-effectiveness.
- The findings support the value of widespread implementation of MRSA prevention strategies.
