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2012-12-01Zeitschriftenartikel DOI: 10.1186/1472-6963-12-438
Cost comparison of MRSA screening and management – a decision tree analysis
dc.contributor.authorTübbicke, Andrea
dc.contributor.authorHübner, Claudia
dc.contributor.authorHübner, Nils-Olaf
dc.contributor.authorWegner, Christian
dc.contributor.authorKramer, Axel
dc.contributor.authorFleßa, Steffen
dc.date.accessioned2018-05-07T16:22:29Z
dc.date.available2018-05-07T16:22:29Z
dc.date.created2013-04-10
dc.date.issued2012-12-01none
dc.identifier.otherhttp://edoc.rki.de/oa/articles/reeu5lOtjbZn/PDF/27u7QqJhsHZh2.pdf
dc.identifier.urihttp://edoc.rki.de/176904/1452
dc.description.abstractBackground: Methicillin-resistant Staphylococcus aureus (MRSA) infections represent a serious challenge for health-care institutions. Rapid and precise identification of MRSA carriers can help to reduce both nosocomial transmissions and unnecessary isolations and associated costs. The practical details of MRSA screenings (who, how, when and where to screen) remain a controversial issue. Methods: Aim of this study was to determine which MRSA screening and management strategy causes the lowest expected cost for a hospital. For this cost analysis a decision analytic cost model was developed, primary based on data from peer-reviewed literature. Single and multiplex sensitivity analyses of the parameters “costs per MRSA case per day”, “costs for pre-emptive isolation per day”, “MRSA rate of transmission not in isolation per day” and “MRSA prevalence” were conducted. Results: The omission of MRSA screening was identified as the alternative with the highest risk for the hospital. Universal MRSA screening strategies are by far more cost-intensive than targeted screening approaches. Culture confirmation of positive PCR results in combination with pre-emptive isolation generates the lowest costs for a hospital. This strategy minimizes the chance of false-positive results as well as the possibility of MRSA cross transmissions and therefore contains the costs for the hospital. These results were confirmed by multiplex and single sensitivity analyses. Single sensitivity analyses have shown that the parameters “MRSA prevalence” and the “rate of MRSA of transmission per day of non-isolated patients” exert the greatest influence on the choice of the favorite screening strategy. Conclusions: It was shown that universal MRSA screening strategies are far more cost-intensive than the targeted screening approaches. In addition, it was demonstrated that all targeted screening strategies produce lower costs than not performing a screening at all.eng
dc.language.isoeng
dc.publisherRobert Koch-Institut, Infektionskrankheiten / Erreger
dc.subjectHumanseng
dc.subjectCost-Benefit Analysiseng
dc.subjectCross Infection/diagnosiseng
dc.subjectCross Infection/drug therapyeng
dc.subjectCross Infection/prevention & controleng
dc.subjectDecision Treeseng
dc.subjectHospital Costseng
dc.subjectMass Screening/economicseng
dc.subjectMass Screening/methodseng
dc.subjectMethicillin-Resistant Staphylococcus aureuseng
dc.subjectPatient Isolation/economicseng
dc.subjectPatient Isolation/methodseng
dc.subjectStaphylococcal Infections/diagnosiseng
dc.subjectStaphylococcal Infections/drug therapyeng
dc.subject.ddc610 Medizin
dc.titleCost comparison of MRSA screening and management – a decision tree analysis
dc.typeperiodicalPart
dc.identifier.urnurn:nbn:de:0257-10030015
dc.identifier.doi10.1186/1472-6963-12-438
dc.identifier.doihttp://dx.doi.org/10.25646/1377
local.edoc.container-titleBMC Health Services Research
local.edoc.fp-subtypeArtikel
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttp://www.biomedcentral.com/1472-6963/12/438
local.edoc.container-publisher-nameBioMedCentral
local.edoc.container-volume12
local.edoc.container-issue438
local.edoc.container-year2013

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