National Costs Associated With Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus Hospitalizations in the United States, 2010-2014.
National Costs Associated With Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus Hospitalizations in the United States, 2010-2014.
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DOI：
10.1093/cid/ciy399
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发表时间：
2019-01-01
期刊：
影响因子：
--
通讯作者：
Perl TM
中科院分区：
文献类型：
--
作者：
Klein EY;Jiang W;Mojica N;Tseng KK;McNeill R;Cosgrove SE;Perl TM
先前的研究发现，耐甲氧西林金黄色葡萄球菌(MRSA)感染的成本高于甲氧西林敏感(MSSA)感染。然而，对最近美国全国住院数据的分析发现，MSSA感染的成本与MRSA感染相同或更高。耐甲氧西林金黄色葡萄球菌(MRSA)感染与甲氧西林敏感(MSSA)感染相比，患者预后更差，护理成本更高。然而，自从先前的研究发现这些差异以来，医疗保健环境发生了变化，包括社区相关MRSA菌株的广泛传播。我们试图提供MRSA感染超额成本的最新估计。我们使用了来自医疗研究和质量局2010-2014年的全国住院患者样本的数据进行了回顾分析。我们计算了住院费用，包括与MRSA和MSSA相关的败血症和肺炎感染，以及来自其他分类条件和未指明地点的MRSA和MSSA相关感染(“其他感染”)。住院费用的差异是使用2010-2014年倾向评分调整后的死亡率结果来估计的。2014年，肺炎和败血症相关住院费用估计最高。MSSA相关肺炎(40725美元对38561美元；P=.045)和其他住院(15578美元对14792美元；P<；.001)的倾向评分调整后的成本显著高于与MRSA相关的住院。从2010年到2013年也观察到了类似的模式，尽管MSSA和MRSA相关肺炎住院治疗的粗成本差异从2010年的25.8%上升到2014年的31.0%。与MSSA相关的住院相比，MRSA相关的住院有更高的调整死亡率。尽管MRSA感染以前与更高的住院费用相关，但我们的结果表明，近年来，与MSSA相关感染相关的成本已与类似MRSA相关住院成本趋同，并可能超过这些成本。
Prior research found that costs for methicillin-resistant Staphylococcus aureus (MRSA) infections were greater than methicillin-susceptible (MSSA) infections. However, analysis of recent US national hospitalization data found that costs for MSSA infections are the same or greater than MRSA infections. Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) have been associated with worse patient outcomes and higher costs of care than methicillin-susceptible (MSSA) infections. However, since prior studies found these differences, the healthcare landscape has changed, including widespread dissemination of community-associated strains of MRSA. We sought to provide updated estimates of the excess costs of MRSA infections. We conducted a retrospective analysis using data from the National Inpatient Sample from the Agency for Healthcare Research and Quality for the years 2010–2014. We calculated costs for hospitalizations, including MRSA- and MSSA-related septicemia and pneumonia infections, as well as MRSA- and MSSA-related infections from conditions classified elsewhere and of an unspecified site (“other infections”). Differences in the costs of hospitalization were estimated using propensity score–adjusted mortality outcomes for 2010–2014. In 2014, estimated costs were highest for pneumonia and sepsis-related hospitalizations. Propensity score–adjusted costs were significantly higher for MSSA-related pneumonia ($40725 vs $38561; P = .045) and other hospitalizations ($15578 vs $14792; P < .001) than for MRSA-related hospitalizations. Similar patterns were observed from 2010 to 2013, although crude cost differences between MSSA- and MRSA-related pneumonia hospitalizations rose from 25.8% in 2010 to 31.0% in 2014. Compared with MSSA-related hospitalizations, MRSA-related hospitalizations had a higher adjusted mortality rate. Although MRSA infections had been previously associated with higher hospitalization costs, our results suggest that, in recent years, costs associated with MSSA-related infections have converged with and may surpass costs of similar MRSA-related hospitalizations.
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影响因子：
3.4
作者：
BARBER, M
通讯作者：
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作者：
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