The impact of methicillin-resistant S. aureus on length of stay, readmissions and costs: a register based case-control study of patients hospitalized in Norway

Abstract

BackgroundPatients with methicillin-resistant S. aureus (MRSA) are thought to incur additional costs for hospitals due to longer stay and contact isolation. The aim of this study was to assess the costs associated with MRSA in Norwegian hospitals.MethodsAnalyses were based on data fromSouth-Eastern Norway for the year 2012 as registered in the Norwegian Surveillance System for Communicable Diseases and the Norwegian Patient Registry. We used a matched case-control method to compare MRSA diagnosed inpatients with non-MRSA inpatients in terms of length of stay, readmissions within 30 days from discharge, as well as the Diagnosis-Related Group (DRG) based costs.ResultsNorwegian patients with MRSA stayed on average 8 days longer in hospital than controls, corresponding to a ratio of mean duration of 2.08 (CI 95%, 1.75–2.47) times longer.A total of 14% of MRSA positive inpatients were readmitted compared to 10% among controls. However, the risk of readmission was not significantly higher for patients with MRSA. DRG based hospital costs were 0.37 (95% CI, 0.19–0.54) times higher among cases than controls, with a mean cost of EUR13,233(SD 26,899) and EUR7198(SD 18,159) respectively.ConclusionThe results of this study indicate that Norwegian patients with MRSA have longer hospital stays, and higher costs than those without MRSA.

A Payer Perspective of the Hospital Inpatient Additional Care Costs of Antimicrobial Resistance in France: A Matched Case–Control Study

“…For example, excess cost estimate for infection due to extended-spectrum β-lactamase (ESBL)-producing bacteria reached − US$2081 [− EUR1905 (conversion to 2015 euros)] to US$10,154 (EUR9295) per case [ 18 ]. Several European studies used a payer’s perspective based on DRG-payment system (diagnosis-related group) to calculate the additional costs of AMR in hospitals [ 19 , 20 ]. From a Norwegian surveillance system and a patient registry, hospital costs for inpatients with methicillin-resistant Staphylococcus aureus (MRSA) reached EUR13,233, while in the control group not diagnosed with MRSA, the hospital cost estimated through the DRG-cost was EUR 7198 [ 19 ].…”

“…Several European studies used a payer’s perspective based on DRG-payment system (diagnosis-related group) to calculate the additional costs of AMR in hospitals [ 19 , 20 ]. From a Norwegian surveillance system and a patient registry, hospital costs for inpatients with methicillin-resistant Staphylococcus aureus (MRSA) reached EUR13,233, while in the control group not diagnosed with MRSA, the hospital cost estimated through the DRG-cost was EUR 7198 [ 19 ]. In a Swiss 2200-bed hospital, the average bed-day cost for MRSA-infected patients was estimated to be 1.5-fold higher when compared with the general population hospitalized in acute wards [ 20 ].…”

Economic evaluation of the treatment of Acute Bacterial Skin and Skin Structure Infections (ABSSSIs) from the national payer perspective: introduction of a new treatment to the patient journey. A simulation of three European countries

“…Hospital LoS is commonly considered by several authors the most important variable driving total healthcare costs in patients with different health conditions [35][36][37]; even if national healthcare providers usually pay hospitals through DRGs to standardize the financial contributions for the treatment of the same health conditions, over the threshold LoSs frequently occur due to adverse events, contributing to a further increase in the economic healthcare burden [38]. The nephrotoxicity [40].…”

Healthcare-associated pneumonia: a prospective study in Spain

“…As such, they require longer hospital stays [6] and, as our results suggest, this time depends on the microorganism identified as causative agent. Specifically, patients with MRSA pneumonia showed the longest LOS, underlining the problems that this pathology represents in terms of management and costs, as discussed by other authors [37]. Although it was not possible to evaluate the influence of treatment on outcomes, the etiology of pneumonia appears to be an important factor when evaluating the outcomes and treatment required by these patients.…”