Abstract
Background: Patients with Methicillin-resistant Staphylococcus aureus (MRSA) are thought to produce additional costs for hospitals, mainly driven by their length of stay and the costs associated with keeping the patients isolated. Objective: The aim of our study was to assess the costs of MRSA diagnosed patients based on their length of stay, number of episodes of care, and DRG reimbursement, as well as to map out the characteristics of this patient group. Methods: Our analyses were based on data from the year 2012 for the South-Eastern Norway Regional Health Authority as reported and registered in the Norwegian Surveillance System for Communicable Diseases and the Norwegian Patient Registry. We estimated excess length of stay by: (i) matching MRSA diagnosed inpatients with non-MRSA inpatients according to DRG code; (ii) matching MRSA diagnosed inpatients with non-MRSA inpatients based on hospital ward. We estimated the economic burden by: (i) matching MRSA diagnosed inpatients with non-MRSA inpatients based on primary diagnosis and then found the mean DRG reimbursement per group; (ii) matching MRSA diagnosed inpatients with non-MRSA inpatients based on hospital ward and compared the mean DRG reimbursement; (iii) matching MRSA diagnosed outpatients and day patients with non-MRSA patients based on ward and compared the mean DRG reimbursement. We estimated episodes of care by: (i) matching all MRSA diagnosed patients with non-MRSA patients based on hospital ward; (ii) matching MRSA diagnosed outpatients and day patients to non-MRSA patients based on ward to compare the number of subsequent episodes of hospital care per group. Results: The mean length of stay for MRSA inpatients (n=174) was 8.5 and 8.2 days compared with controls, who had a mean length of stay of 5.4 and 4.6 days when matched on DRG code and ward, respectively. The DRG reimbursement for MRSA inpatients was NOK71,206 and NOK74,644 compared with NOK56,653 and NOK49,511 for controls matched based on primary diagnosis and ward, respectively. MRSA inpatients had nearly double (1.5) the number of subsequent episodes per patient compared with controls (0.8) matched on ward. All MRSA patients (n=315), outpatients (n=241), and day patients (n=20), had fewer subsequent episodes of care compared with their controls. Conclusion: This analysis indicates the economic impact of patients with MRSA diagnoses, having 26%-50% higher costs than others. Further detailed cost-effectiveness analysis is advised so that policy makers can make informed decisions regarding infection control measures.
Background: Patients with Methicillin-resistant Staphylococcus aureus (MRSA) are thought to produce additional costs for hospitals, mainly driven by their length of stay and the costs associated with keeping the patients isolated. Objective: The aim of our study was to assess the costs of MRSA diagnosed patients based on their length of stay, number of episodes of care, and DRG reimbursement, as well as to map out the characteristics of this patient group. Methods: Our analyses were based on data from the year 2012 for the South-Eastern Norway Regional Health Authority as reported and registered in the Norwegian Surveillance System for Communicable Diseases and the Norwegian Patient Registry. We estimated excess length of stay by: (i) matching MRSA diagnosed inpatients with non-MRSA inpatients according to DRG code; (ii) matching MRSA diagnosed inpatients with non-MRSA inpatients based on hospital ward. We estimated the economic burden by: (i) matching MRSA diagnosed inpatients with non-MRSA inpatients based on primary diagnosis and then found the mean DRG reimbursement per group; (ii) matching MRSA diagnosed inpatients with non-MRSA inpatients based on hospital ward and compared the mean DRG reimbursement; (iii) matching MRSA diagnosed outpatients and day patients with non-MRSA patients based on ward and compared the mean DRG reimbursement. We estimated episodes of care by: (i) matching all MRSA diagnosed patients with non-MRSA patients based on hospital ward; (ii) matching MRSA diagnosed outpatients and day patients to non-MRSA patients based on ward to compare the number of subsequent episodes of hospital care per group. Results: The mean length of stay for MRSA inpatients (n=174) was 8.5 and 8.2 days compared with controls, who had a mean length of stay of 5.4 and 4.6 days when matched on DRG code and ward, respectively. The DRG reimbursement for MRSA inpatients was NOK71,206 and NOK74,644 compared with NOK56,653 and NOK49,511 for controls matched based on primary diagnosis and ward, respectively. MRSA inpatients had nearly double (1.5) the number of subsequent episodes per patient compared with controls (0.8) matched on ward. All MRSA patients (n=315), outpatients (n=241), and day patients (n=20), had fewer subsequent episodes of care compared with their controls. Conclusion: This analysis indicates the economic impact of patients with MRSA diagnoses, having 26%-50% higher costs than others. Further detailed cost-effectiveness analysis is advised so that policy makers can make informed decisions regarding infection control measures.