Abstract
[Background] Methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacteria that does not react to certain antibiotics and has become the major cause of nosocomial infections. Both the treatments and precautions of MRSA add to the burden of infections caused by S. aureus. To reduce the costs, Oslo University Hospital, Ullevål introduced the GeneXpert system to help accelerating the procedure of screening.
[Objective] The aim of the study was to estimate the additional costs and outcomes of replacing the current used screening strategy with new strategies which involved the GeneXpert system in patients at high risk of MRSA.
[Methods] We developed a decision model to represent the current strategy and two new strategies with the GeneXpert system, and measured costs and outcomes (length of preemptive isolation, number of unavailable room-hours, quality of life) for each of them.
[Results] While the cost of the current strategy was NOK16,984, the results showed that the new strategies were much less costly than the current used one (NOK7,360 and NOK3,690). The new strategies reduced the length of preemptive isolation and the number of unavailable room-hours and improved patients’ quality of life. The sensitivity analyses indicated that these results were not sensitive to reasonable changes in the model parameters.
[Conclusions] The new GeneXpert system represents a dominant strategy in that it reduces costs and improves outcomes under reasonable assumptions.