模拟放松的政策,停止耐甲基黄金葡萄球菌的接触预防措施
Jiaming Cui1, Jack Heavey2, Leo Lin2
1College of Computing, Georgia Institute of Technology, Atlanta, Georgia.
Infection control and hospital epidemiology
|February 26, 2024
概括
减少甲素耐药黄金葡萄球菌 (MRSA) 接触预防措施,以一个负测试结果显著降低医院成本. 单个负的MRSA测试可能是停止预防措施的最具成本效益的策略.
科学领域:
- 传染病流行病学 传染病流行病学
- 卫生经济学 卫生经济学
- 医院感染控制中心
背景情况:
- 弗吉尼亚大学医院目前采用"3-负"政策,停止使用耐甲基金色葡萄球菌 (MRSA) 接触预防措施.
- 这一政策要求在解除接触预防措施之前,连续三次检测结果呈阴性.
- 评估更少负面测试的替代政策对于优化患者护理和资源配置至关重要.
研究的目的:
- 评估与将MRSA"3-负"政策降低为"2-负"或"1-负"政策相关的经济成本.
- 在弗吉尼亚大学医院比较不同MRSA清除策略的成本效益.
主要方法:
- 在2015年至2019年期间,使用来自41,216名患者的数据进行了成本效益分析.
- 使用电子健康记录数据开发了一个模拟MRSA传播的数学模型,结合了环境和患者-提供者相互作用.
- 反事实模拟将现有的3负政策与假设的2负和1负政策进行了比较.
主要成果:
- 预计2负和1负政策将导致6个和17个额外的MRSA病例,相比3负政策.
- 1负策略显示,与2负策略 (687,946美元) 和3负策略 (702,823美元) 相比,每年节省628,452美元的统计学上显著的成本.
- 这些成本节省在2023年经通胀调整后实现.
结论:
- 一个单个负的MRSA病毒PCR测试可能足以停止接触预防措施.
- 一个负的政策似乎是最具成本效益的策略来管理MRSA在这个医院环境.
- 实施1负政策可以在管理MRSA传播的同时大幅降低成本.
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