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The Impact of Healthcare-Associated Methicillin-Resistant Staphylococcus aureus Infections on Postdischarge Health Care Costs and Utilization across Multiple Health Care Systems.
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- Author(s): Nelson, Richard E.; Jones, Makoto; Liu, Chuan‐Fen; Samore, Matthew H.; Evans, Martin E.; Stevens, Vanessa W.; Reese, Thomas; Rubin, Michael A.; Liu, Chuan-Fen
- Source:
Health Services Research; Dec2018 Supplement S3, Vol. 53, p5419-5437, 19p, 3 Charts, 2 Graphs- Subject Terms:
HEALTH facilities; MEDICAL care; PUBLIC health; METHICILLIN-resistant staphylococcus aureus; ECONOMIC impact; MEDICARE; MEDICAL care use; MEDICAL care cost statistics; COMPARATIVE studies; CROSS infection; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RESEARCH funding; STAPHYLOCOCCAL diseases; SOCIOECONOMIC factors; EVALUATION research; DISCHARGE planning; PATIENTS' attitudes; ECONOMICS - Source:
- Additional Information
- Subject Terms:
- Subject Terms:
- Abstract:
Objective: To measure how much of the postdischarge cost and utilization attributable to methicillin-resistant Staphylococcus aureus (MRSA) health care-associated infections (HAIs) occur within the US Department of Veterans Affairs (VA) system and how much occurs outside.Data Sources/study Setting: Health care encounters from 3 different settings and payment models: (1) within the VA; (2) outside the VA but paid for by the VA (purchased care); and (3) outside the VA and paid for by Medicare.Study Design: Historical cohort study using data from admissions to VA hospitals between 2007 and 2012.Methods: We assessed the impact of a positive MRSA test result on costs and utilization during the 365 days following discharge using inverse probability of treatment weights to balance covariates.Principal Findings: Among a cohort of 152,687 hospitalized Veterans, a positive MRSA test result was associated with an overall increase of 6.6 (95 percent CI: 5.7-7.5) inpatient days and $9,237 (95 percent CI: $8,211-$10,262) during the postdischarge period. VA inpatient admissions, Medicare reimbursements, and purchased care payments accounted for 60.6 percent, 22.5 percent, and 16.9 percent of these inpatient costs.Conclusions: While most of the excess postdischarge health care costs associated with MRSA HAIs occurred in the VA, non-VA costs make up an important subset of the overall burden. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of Health Services Research is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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