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Additional Costs for Preventing the Spread of Methicillin-Resistant Staphylococcus aureus and a Strategy for Reducing These Costs on a Surgical Ward

Published online by Cambridge University Press:  02 January 2015

Caroline Eva Wella Herr ,
Thomas Hilarius Heckrodt ,
Frank Andreas Hofmann ,
Reinhard Schnettler  and
Thomas Friedrich Eikmann
Caroline Eva Wella Herr*
Affiliation:
Institute of Hygiene and Environmental Medicine, Justus-Liebig University of Giessen, Giessen, Germany
Thomas Hilarius Heckrodt
Affiliation:
Institute of Hygiene and Environmental Medicine, Justus-Liebig University of Giessen, Giessen, Germany
Frank Andreas Hofmann
Affiliation:
Institute of Hygiene and Environmental Medicine, Justus-Liebig University of Giessen, Giessen, Germany
Reinhard Schnettler
Affiliation:
Clinic for Casualty (Emergency) Surgery, Justus-Liebig University of Giessen, Giessen, Germany
Thomas Friedrich Eikmann
Affiliation:
Institute of Hygiene and Environmental Medicine, Justus-Liebig University of Giessen, Giessen, Germany
*
Institute of Hygiene and Environmental Medicine, Justus-Liebig University of Giessen, Friedrichstrasse 16, D-35385 Giessen, Germany
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Abstract

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.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 9 , September 2003 , pp. 673 - 678
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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