European Society of Clinical Infectious Diseases. Published by Elsevier Ltd.
Doi
Abstract
AbstractInfections caused by methicillin-resistant Staphylococcus aureus (MRSA) incur significant costs. We aimed to examine the cost and cost-benefit of infection control interventions against MRSA and to examine factors affecting economic estimates. We performed a systematic review of studies assessing infection control interventions aimed at preventing spread of MRSA in hospitals and reporting intervention costs, savings, cost-benefit or cost-effectiveness. We searched PubMed and references of included studies with no language restrictions up to January 2012. We used the Quality of Health Economic Studies tool to assess study quality. We report cost and savings per month in 2011 US.Wecalculatedthemediansave/costratioandthesave−costdifferencewithinterquartilerange(IQR)range.WeexaminedtheeffectsofMRSAendemicity,interventiondurationandhospitalsizeonresults.Thirty−sixstudiespublishedbetween1987and2011fulfilledinclusioncriteria.Fifteenofthe18studiesreportingbothcostsandsavingsreportedasave/costratio>1.Themediansave/costratioacrossall18studieswas7.16(IQR1.37–16).Themediancostacrossallstudiesreportinginterventioncosts(n=31)was8648(IQR2025–19170)US per month; median savings were 38 751 (IQR 14 206–75 842) US$ per month (23 studies). Higher save/cost ratios were observed in the intermediate to high endemicity setting compared with the low endemicity setting, in hospitals with <500-beds and with interventions of >6 months. Infection control intervention to reduce spread of MRSA in acute-care hospitals showed a favourable cost/benefit ratio. This was true also for high MRSA endemicity settings. Unresolved economic issues include rapid screening using molecular techniques and universal versus targeted screening