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Title: Modeling relaxed policies for discontinuation of methicillin-resistant Staphylococcus aureus contact precautions
Abstract Objective:To evaluate the economic costs of reducing the University of Virginia Hospital’s present “3-negative” policy, which continues methicillin-resistantStaphylococcus aureus(MRSA) contact precautions until patients receive 3 consecutive negative test results, to either 2 or 1 negative. Design:Cost-effective analysis. Settings:The University of Virginia Hospital. Patients:The study included data from 41,216 patients from 2015 to 2019. Methods:We developed a model for MRSA transmission in the University of Virginia Hospital, accounting for both environmental contamination and interactions between patients and providers, which were derived from electronic health record (EHR) data. The model was fit to MRSA incidence over the study period under the current 3-negative clearance policy. A counterfactual simulation was used to estimate outcomes and costs for 2- and 1-negative policies compared with the current 3-negative policy. Results:Our findings suggest that 2-negative and 1-negative policies would have led to 6 (95% CI, −30 to 44;P< .001) and 17 (95% CI, −23 to 59; −10.1% to 25.8%;P< .001) more MRSA cases, respectively, at the hospital over the study period. Overall, the 1-negative policy has statistically significantly lower costs ($628,452; 95% CI, $513,592–$752,148) annually (P< .001) in US dollars, inflation-adjusted for 2023) than the 2-negative policy ($687,946; 95% CI, $562,522–$812,662) and 3-negative ($702,823; 95% CI, $577,277–$846,605). Conclusions:A single negative MRSA nares PCR test may provide sufficient evidence to discontinue MRSA contact precautions, and it may be the most cost-effective option.  more » « less
Award ID(s):
1955883 2028586 2200269 2106961
PAR ID:
10523665
Author(s) / Creator(s):
; ; ; ; ; ; ; ;
Publisher / Repository:
Cambridge University Press / SHEA
Date Published:
Journal Name:
Infection Control & Hospital Epidemiology
ISSN:
0899-823X
Page Range / eLocation ID:
1 to 6
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
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