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- Publisher Website: 10.1371/journal.pone.0014783
- Scopus: eid_2-s2.0-79953314069
- PMID: 21483492
- WOS: WOS:000289057200002
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Article: Modelling the costs and effects of selective and universal hospital admission screening for methicillin-resistant Staphylococcus aureus
Title | Modelling the costs and effects of selective and universal hospital admission screening for methicillin-resistant Staphylococcus aureus |
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Authors | |
Issue Date | 2011 |
Citation | PLoS ONE, 2011, v. 6, n. 3, article no. e14783 How to Cite? |
Abstract | Background: Screening at hospital admission for carriage of methicillin-resistant Staphylococcus aureus (MRSA) has been proposed as a strategy to reduce nosocomial infections. The objective of this study was to determine the long-term costs and health benefits of selective and universal screening for MRSA at hospital admission, using both PCR-based and chromogenic media-based tests in various settings. Methodology/Principal Findings: A simulation model of MRSA transmission was used to determine costs and effects over 15 years from a US healthcare perspective. We compared admission screening together with isolation of identified carriers against a baseline policy without screening or isolation. Strategies included selective screening of high risk patients or universal admission screening, with PCR-based or chromogenic media-based tests, in medium (5%) or high nosocomial prevalence (15%) settings. The costs of screening and isolation per averted MRSA infection were lowest using selective chromogenic-based screening in high and medium prevalence settings, at $4,100 and $10,300, respectively. Replacing the chromogenic-based test with a PCR-based test costs $13,000 and $36,200 per additional infection averted, and subsequent extension to universal screening with PCR would cost $131,000 and $232,700 per additional infection averted, in high and medium prevalence settings respectively. Assuming $17,645 benefit per infection averted, the most cost-saving strategies in high and medium prevalence settings were selective screening with PCR and selective screening with chromogenic, respectively. Conclusions/Significance: Admission screening costs $4,100-$21,200 per infection averted, depending on strategy and setting. Including financial benefits from averted infections, screening could well be cost saving. © 2011 Hubben et al. |
Persistent Identifier | http://hdl.handle.net/10722/326859 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Hubben, Gijs | - |
dc.contributor.author | Bootsma, Martin | - |
dc.contributor.author | Luteijn, Michiel | - |
dc.contributor.author | Glynn, Diarmuid | - |
dc.contributor.author | Bishai, David | - |
dc.contributor.author | Bonten, Marc | - |
dc.contributor.author | Postma, Maarten | - |
dc.date.accessioned | 2023-03-31T05:27:03Z | - |
dc.date.available | 2023-03-31T05:27:03Z | - |
dc.date.issued | 2011 | - |
dc.identifier.citation | PLoS ONE, 2011, v. 6, n. 3, article no. e14783 | - |
dc.identifier.uri | http://hdl.handle.net/10722/326859 | - |
dc.description.abstract | Background: Screening at hospital admission for carriage of methicillin-resistant Staphylococcus aureus (MRSA) has been proposed as a strategy to reduce nosocomial infections. The objective of this study was to determine the long-term costs and health benefits of selective and universal screening for MRSA at hospital admission, using both PCR-based and chromogenic media-based tests in various settings. Methodology/Principal Findings: A simulation model of MRSA transmission was used to determine costs and effects over 15 years from a US healthcare perspective. We compared admission screening together with isolation of identified carriers against a baseline policy without screening or isolation. Strategies included selective screening of high risk patients or universal admission screening, with PCR-based or chromogenic media-based tests, in medium (5%) or high nosocomial prevalence (15%) settings. The costs of screening and isolation per averted MRSA infection were lowest using selective chromogenic-based screening in high and medium prevalence settings, at $4,100 and $10,300, respectively. Replacing the chromogenic-based test with a PCR-based test costs $13,000 and $36,200 per additional infection averted, and subsequent extension to universal screening with PCR would cost $131,000 and $232,700 per additional infection averted, in high and medium prevalence settings respectively. Assuming $17,645 benefit per infection averted, the most cost-saving strategies in high and medium prevalence settings were selective screening with PCR and selective screening with chromogenic, respectively. Conclusions/Significance: Admission screening costs $4,100-$21,200 per infection averted, depending on strategy and setting. Including financial benefits from averted infections, screening could well be cost saving. © 2011 Hubben et al. | - |
dc.language | eng | - |
dc.relation.ispartof | PLoS ONE | - |
dc.title | Modelling the costs and effects of selective and universal hospital admission screening for methicillin-resistant Staphylococcus aureus | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1371/journal.pone.0014783 | - |
dc.identifier.pmid | 21483492 | - |
dc.identifier.scopus | eid_2-s2.0-79953314069 | - |
dc.identifier.volume | 6 | - |
dc.identifier.issue | 3 | - |
dc.identifier.spage | article no. e14783 | - |
dc.identifier.epage | article no. e14783 | - |
dc.identifier.eissn | 1932-6203 | - |
dc.identifier.isi | WOS:000289057200002 | - |