387. Assessing Attributable Cost and Length of Stay of Vancomycin Resistant Enterococci (VRE) at a Canadian Hospital
Session: Poster Abstract Session: MRSA, MSSA, Enterococci
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Background: The pressure of competing resource demands on Infection Prevention and Control programs has resulted in the de-escalation or discontinuation of Vancomycin Resistant Enterococci (VRE) programs in some Canadian hospitals. Prior to implementing any change in our VRE program, we decided evaluate the attributable burden of VRE. The objective of this study was to determine the attributable costs and length of stay (LOS) of VRE colonizations/infections in an acute care hospital in Canada.

Methods: We examined surveillance and financial hospital-based databases to conduct analyses with cases and controls from fiscal year 2008/09 (April 1, 2008-March 31, 2009) at an acute care hospital in downtown Vancouver, Canada. We conducted a statistical analysis of attributable costs and LOS using a generalized linear model (GLM).

Results: Our sample included 217 patients with VRE and a random sample of 1,078 patients without VRE. VRE had a positive and significant impact on patient hospitalization costs and LOS. The GLM cost mean was 64.9% (95% Confidence Interval [CI]: 47.0%-85.1%) in relative terms and $18,497 (95% CI: $14,998-$21,570) in absolute dollars. For LOS, the attributable number of days associated with a VRE case mean was 67.8% (95% CI: 47.5%-90.8%) in relative terms and 13.4 days (95% CI: 10.9-15.6) in absolute days.

Conclusion: Based on our analysis, the attributable cost and LOS of VRE are considerable.  The results of this analysis can be used as a basis for a rigorous economic evaluation of the benefits and costs of infection prevention and control programs. Importantly, our results should be taken into consideration before de-escalation of a hospital VRE control program.

Elisa Lloyd-Smith, PhD1, Patrick Lloyd-Smith, MA2, Jaime Younger, MA3, Victor Leung, MD, FRCPC1, Howard Green, MBA4 and Marc G. Romney, MD, FRCPC, DTM&H5, (1)Providence Health Care, Vancouver, BC, Canada, (2)Economics, University of Alberta, Edmonton, AB, Canada, (3)Mayne Economics, Edmonton, AB, Canada, (4)Infection Prevention and Control, Providence Health Care, Vancouver, BC, Canada, (5)Pathology and Laboratory Medicine, Providence Health Care, Vancouver, BC, Canada

Disclosures:

E. Lloyd-Smith, None

P. Lloyd-Smith, None

J. Younger, None

V. Leung, None

H. Green, None

M. G. Romney, Pfizer: Grant Investigator and Scientific Advisor, Consulting fee and Research grant

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