374. Cost-of-illness analysis of Staphylococcus aureus bacteremia
Session: Poster Abstract Session: MRSA, MSSA, Enterococci
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDWeek 2013 Thampi Poster 374.pdf (399.3 kB)
  • Background:

    Staphylococcus aureus is a leading cause of serious bloodstream infections. Methicillin-resistant Staphylococcus aureus (MRSA) has been associated with higher rates of hospitalization and mortality than methicillin-susceptible Staphylococcus aureus (MSSA), especially among patients with additional comorbidities and prolonged hospital courses. We reviewed the clinical and economic burden of newly hospitalized cases of MRSA and MSSA, including cost drivers, in the context of a publicly funded health care system.

    Methods:

    A cost-of-illness analysis was performed for patients diagnosed with Staphylococcus aureus bacteremia (SAB) within 72 hours of admission at 3 academic teaching hospitals in Toronto, Canada, over a 3-year period. The cost per case in Canadian dollars was derived from standardized costing methodology through the Ontario Case Costing Initiative. Associations among MRSA status, clinical course and cost drivers were examined.

    Results:

    From April 2007 to April 2010, 303 patients were admitted with SAB: 39 with MRSA and 264 with MSSA. The average patient was 60 years old (range 17-98 years) and male (63%). The median length of stay was higher among patients with MRSA (22 vs 12 days, P = 0.03). MRSA cases were not associated with higher comorbidities, and rates of ICU admission were similar to MSSA patients (38% vs 28%, P = 0.83). Death occurred in 101 patients, of which 17% were with MRSA bacteremia. Costs were available for 278 patients (35 with MRSA and 243 with MSSA). The median cost per case for MRSA versus MSSA was $25,171 (95% CI $12,323-$38,019) and $15,313 (95% CI $11,977-$18,650; P = 0.2), respectively. The cost drivers in both groups were intensive care and nursing, followed by pharmacy costs related to non-infective agents.

    Conclusion:

    There was no significant difference in hospitalization costs based on methicillin susceptibility despite differences in length of stay. As hospitals move away from health-based allocation funding, understanding the dynamics of resource utilization and costs will become critical to improving quality of care patients receive in a publicly funded health care system.

    Nisha Thampi, MD, MSc1,2,3, Adrienne Showler, MD1, Lisa Burry, PharmD2, Marilyn Steinberg, RN2, Chaim Bell, MD, PhD1,2,4 and Andrew Morris, MD, SM1,2,4, (1)University of Toronto, Toronto, ON, Canada, (2)Mount Sinai Hospital, Toronto, ON, Canada, (3)The Hospital for Sick Children, Toronto, ON, Canada, (4)University Health Network, Toronto, ON, Canada

    Disclosures:

    N. Thampi, None

    A. Showler, None

    L. Burry, None

    M. Steinberg, None

    C. Bell, None

    A. Morris, None

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