A computer simulation model of the cost-effectiveness of routine Staphylococcus aureus screening and decolonization among lung and heart-lung transplant recipients
Our objective was to model the cost-effectiveness and economic value of routine peri-operative Staphylococcus aureus screening and decolonization of lung and heart-lung transplant recipients from hospital and third-party payer perspectives. We used clinical data from 596 lung and heart-lung transpla...
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| Veröffentlicht in: | European journal of clinical microbiology & infectious diseases 2014-06, Vol.33 (6), p.1053-1061 |
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| creator | Clancy, C. J. Bartsch, S. M. Nguyen, M. H. Stuckey, D. R. Shields, R. K. Lee, B. Y. |
| description | Our objective was to model the cost-effectiveness and economic value of routine peri-operative
Staphylococcus aureus
screening and decolonization of lung and heart-lung transplant recipients from hospital and third-party payer perspectives. We used clinical data from 596 lung and heart-lung transplant recipients to develop a model in TreeAge Pro 2009 (Williamsport, MA, USA). Sensitivity analyses varied
S. aureus
colonization rate (5–15 %), probability of infection if colonized (10–30 %), and decolonization efficacy (25–90 %). Data were collected from the Cardiothoracic Transplant Program at the University of Pittsburgh Medical Center. Consecutive lung and heart-lung transplant recipients from January 2006 to December 2010 were enrolled retrospectively. Baseline rates of
S. aureus
colonization, infection and decolonization efficacy were 9.6 %, 36.7 %, and 31.9 %, respectively. Screening and decolonization was economically dominant for all scenarios tested, providing more cost savings and health benefits than no screening. Savings per case averted (2012 $US) ranged from $73,567 to $133,157 (hospital perspective) and $10,748 to $16,723 (third party payer perspective), varying with the probability of colonization, infection, and decolonization efficacy. Using our clinical data, screening and decolonization led to cost savings per case averted of $240,602 (hospital perspective) and averted 6.7
S. aureus
infections (4.3 MRSA and 2.4 MSSA); 89 patients needed to be screened to prevent one
S. aureus
infection. Our data support routine
S. aureus
screening and decolonization of lung and heart-lung transplant patients. The economic value of screening and decolonization was greater than in previous models of other surgical populations. |
| doi_str_mv | 10.1007/s10096-013-2046-y |
| format | Article |
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Staphylococcus aureus
screening and decolonization of lung and heart-lung transplant recipients from hospital and third-party payer perspectives. We used clinical data from 596 lung and heart-lung transplant recipients to develop a model in TreeAge Pro 2009 (Williamsport, MA, USA). Sensitivity analyses varied
S. aureus
colonization rate (5–15 %), probability of infection if colonized (10–30 %), and decolonization efficacy (25–90 %). Data were collected from the Cardiothoracic Transplant Program at the University of Pittsburgh Medical Center. Consecutive lung and heart-lung transplant recipients from January 2006 to December 2010 were enrolled retrospectively. Baseline rates of
S. aureus
colonization, infection and decolonization efficacy were 9.6 %, 36.7 %, and 31.9 %, respectively. Screening and decolonization was economically dominant for all scenarios tested, providing more cost savings and health benefits than no screening. Savings per case averted (2012 $US) ranged from $73,567 to $133,157 (hospital perspective) and $10,748 to $16,723 (third party payer perspective), varying with the probability of colonization, infection, and decolonization efficacy. Using our clinical data, screening and decolonization led to cost savings per case averted of $240,602 (hospital perspective) and averted 6.7
S. aureus
infections (4.3 MRSA and 2.4 MSSA); 89 patients needed to be screened to prevent one
S. aureus
infection. Our data support routine
S. aureus
screening and decolonization of lung and heart-lung transplant patients. The economic value of screening and decolonization was greater than in previous models of other surgical populations.</description><identifier>ISSN: 0934-9723</identifier><identifier>EISSN: 1435-4373</identifier><identifier>DOI: 10.1007/s10096-013-2046-y</identifier><identifier>PMID: 24500598</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Academic Medical Centers ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacterial diseases ; Biological and medical sciences ; Biomedical and Life Sciences ; Biomedicine ; Carrier State - diagnosis ; Carrier State - drug therapy ; Child ; Child, Preschool ; Cohort Studies ; Colonization ; Computer Simulation ; Cost analysis ; Cost control ; Cost-Benefit Analysis ; Decolonization ; Economics ; Female ; Heart ; Heart Transplantation ; Hospitals ; Human bacterial diseases ; Humans ; Infant ; Infectious diseases ; Internal Medicine ; Lung Transplantation ; Lung transplants ; Male ; Mass Screening - economics ; Mass Screening - methods ; Medical Microbiology ; Medical sciences ; Middle Aged ; Pennsylvania ; Pneumonia ; Retrospective Studies ; Sensitivity analysis ; Staphylococcal Infections - diagnosis ; Staphylococcal Infections - drug therapy ; Staphylococcal infections, streptococcal infections, pneumococcal infections ; Staphylococcus aureus ; Staphylococcus aureus - isolation & purification ; Staphylococcus infections ; Transplant Recipients ; Young Adult</subject><ispartof>European journal of clinical microbiology & infectious diseases, 2014-06, Vol.33 (6), p.1053-1061</ispartof><rights>Springer-Verlag Berlin Heidelberg 2014</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c603t-adcc3640f884487afe6771be7fc578b750dff76789872535a2521a6dd83782ea3</citedby><cites>FETCH-LOGICAL-c603t-adcc3640f884487afe6771be7fc578b750dff76789872535a2521a6dd83782ea3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10096-013-2046-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10096-013-2046-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28577564$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24500598$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Clancy, C. J.</creatorcontrib><creatorcontrib>Bartsch, S. M.</creatorcontrib><creatorcontrib>Nguyen, M. H.</creatorcontrib><creatorcontrib>Stuckey, D. R.</creatorcontrib><creatorcontrib>Shields, R. K.</creatorcontrib><creatorcontrib>Lee, B. Y.</creatorcontrib><title>A computer simulation model of the cost-effectiveness of routine Staphylococcus aureus screening and decolonization among lung and heart-lung transplant recipients</title><title>European journal of clinical microbiology & infectious diseases</title><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><description>Our objective was to model the cost-effectiveness and economic value of routine peri-operative
Staphylococcus aureus
screening and decolonization of lung and heart-lung transplant recipients from hospital and third-party payer perspectives. We used clinical data from 596 lung and heart-lung transplant recipients to develop a model in TreeAge Pro 2009 (Williamsport, MA, USA). Sensitivity analyses varied
S. aureus
colonization rate (5–15 %), probability of infection if colonized (10–30 %), and decolonization efficacy (25–90 %). Data were collected from the Cardiothoracic Transplant Program at the University of Pittsburgh Medical Center. Consecutive lung and heart-lung transplant recipients from January 2006 to December 2010 were enrolled retrospectively. Baseline rates of
S. aureus
colonization, infection and decolonization efficacy were 9.6 %, 36.7 %, and 31.9 %, respectively. Screening and decolonization was economically dominant for all scenarios tested, providing more cost savings and health benefits than no screening. Savings per case averted (2012 $US) ranged from $73,567 to $133,157 (hospital perspective) and $10,748 to $16,723 (third party payer perspective), varying with the probability of colonization, infection, and decolonization efficacy. Using our clinical data, screening and decolonization led to cost savings per case averted of $240,602 (hospital perspective) and averted 6.7
S. aureus
infections (4.3 MRSA and 2.4 MSSA); 89 patients needed to be screened to prevent one
S. aureus
infection. Our data support routine
S. aureus
screening and decolonization of lung and heart-lung transplant patients. The economic value of screening and decolonization was greater than in previous models of other surgical populations.</description><subject>Academic Medical Centers</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Carrier State - diagnosis</subject><subject>Carrier State - drug therapy</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cohort Studies</subject><subject>Colonization</subject><subject>Computer Simulation</subject><subject>Cost analysis</subject><subject>Cost control</subject><subject>Cost-Benefit Analysis</subject><subject>Decolonization</subject><subject>Economics</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Transplantation</subject><subject>Hospitals</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infant</subject><subject>Infectious diseases</subject><subject>Internal Medicine</subject><subject>Lung Transplantation</subject><subject>Lung transplants</subject><subject>Male</subject><subject>Mass Screening - economics</subject><subject>Mass Screening - methods</subject><subject>Medical Microbiology</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pennsylvania</subject><subject>Pneumonia</subject><subject>Retrospective Studies</subject><subject>Sensitivity analysis</subject><subject>Staphylococcal Infections - diagnosis</subject><subject>Staphylococcal Infections - drug therapy</subject><subject>Staphylococcal infections, streptococcal infections, pneumococcal infections</subject><subject>Staphylococcus aureus</subject><subject>Staphylococcus aureus - isolation & purification</subject><subject>Staphylococcus infections</subject><subject>Transplant Recipients</subject><subject>Young Adult</subject><issn>0934-9723</issn><issn>1435-4373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkk1rFTEUhgdR7LX6A9zIgAjdjOZzktkIpVgVCi7UdcjNnNybMpOMSaZw-3f8o2aca62C4CaH8D7nK3mr6jlGrzFC4k0qZ9c2CNOGINY2hwfVBjPKG0YFfVhtUEdZ0wlCT6onKV2jkiOFeFydEMYR4p3cVN_PaxPGac4Q6-TGedDZBV-PoYehDrbOeyhAyg1YCya7G_CQ0qLEMGfnof6c9bQ_DMEEY-ZU6zlCCclEAO_8rta-r3swYQje3a7V9RiKMMxHdQ865ubnNUft0zRon-sIxk0OfE5Pq0dWDwmeHeNp9fXy3ZeLD83Vp_cfL86vGtMimhvdG0NbhqyUjEmhLbRC4C0Ia7iQW8FRb61oheykIJxyTTjBuu17SYUkoOlp9XatO83bEXpTekc9qCm6UceDCtqpPxXv9moXbpSkWFLJSoGzY4EYvs2QshpdMjCUfSDMSWFOmSRMtvw_UEIZIrQlBX35F3od5ujLSywUlp2gGBUKr5SJIaUI9m5ujNTiFrW6RRW3qMUt6lByXtxf-C7jlz0K8OoI6GT0YMvvGJd-c5ILwdtlcbJyqUh-B_HeiP_s_gNo0NyK</recordid><startdate>20140601</startdate><enddate>20140601</enddate><creator>Clancy, C. 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J. ; Bartsch, S. M. ; Nguyen, M. H. ; Stuckey, D. R. ; Shields, R. K. ; Lee, B. 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J.</creatorcontrib><creatorcontrib>Bartsch, S. M.</creatorcontrib><creatorcontrib>Nguyen, M. H.</creatorcontrib><creatorcontrib>Stuckey, D. R.</creatorcontrib><creatorcontrib>Shields, R. K.</creatorcontrib><creatorcontrib>Lee, B. 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J.</au><au>Bartsch, S. M.</au><au>Nguyen, M. H.</au><au>Stuckey, D. R.</au><au>Shields, R. K.</au><au>Lee, B. Y.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A computer simulation model of the cost-effectiveness of routine Staphylococcus aureus screening and decolonization among lung and heart-lung transplant recipients</atitle><jtitle>European journal of clinical microbiology & infectious diseases</jtitle><stitle>Eur J Clin Microbiol Infect Dis</stitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><date>2014-06-01</date><risdate>2014</risdate><volume>33</volume><issue>6</issue><spage>1053</spage><epage>1061</epage><pages>1053-1061</pages><issn>0934-9723</issn><eissn>1435-4373</eissn><abstract>Our objective was to model the cost-effectiveness and economic value of routine peri-operative
Staphylococcus aureus
screening and decolonization of lung and heart-lung transplant recipients from hospital and third-party payer perspectives. We used clinical data from 596 lung and heart-lung transplant recipients to develop a model in TreeAge Pro 2009 (Williamsport, MA, USA). Sensitivity analyses varied
S. aureus
colonization rate (5–15 %), probability of infection if colonized (10–30 %), and decolonization efficacy (25–90 %). Data were collected from the Cardiothoracic Transplant Program at the University of Pittsburgh Medical Center. Consecutive lung and heart-lung transplant recipients from January 2006 to December 2010 were enrolled retrospectively. Baseline rates of
S. aureus
colonization, infection and decolonization efficacy were 9.6 %, 36.7 %, and 31.9 %, respectively. Screening and decolonization was economically dominant for all scenarios tested, providing more cost savings and health benefits than no screening. Savings per case averted (2012 $US) ranged from $73,567 to $133,157 (hospital perspective) and $10,748 to $16,723 (third party payer perspective), varying with the probability of colonization, infection, and decolonization efficacy. Using our clinical data, screening and decolonization led to cost savings per case averted of $240,602 (hospital perspective) and averted 6.7
S. aureus
infections (4.3 MRSA and 2.4 MSSA); 89 patients needed to be screened to prevent one
S. aureus
infection. Our data support routine
S. aureus
screening and decolonization of lung and heart-lung transplant patients. The economic value of screening and decolonization was greater than in previous models of other surgical populations.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>24500598</pmid><doi>10.1007/s10096-013-2046-y</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | European journal of clinical microbiology & infectious diseases, 2014-06, Vol.33 (6), p.1053-1061 |
| issn | 0934-9723 1435-4373 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8318384 |
| source | MEDLINE; Springer Online Journals Complete |
| subjects | Academic Medical Centers Adolescent Adult Aged Aged, 80 and over Bacterial diseases Biological and medical sciences Biomedical and Life Sciences Biomedicine Carrier State - diagnosis Carrier State - drug therapy Child Child, Preschool Cohort Studies Colonization Computer Simulation Cost analysis Cost control Cost-Benefit Analysis Decolonization Economics Female Heart Heart Transplantation Hospitals Human bacterial diseases Humans Infant Infectious diseases Internal Medicine Lung Transplantation Lung transplants Male Mass Screening - economics Mass Screening - methods Medical Microbiology Medical sciences Middle Aged Pennsylvania Pneumonia Retrospective Studies Sensitivity analysis Staphylococcal Infections - diagnosis Staphylococcal Infections - drug therapy Staphylococcal infections, streptococcal infections, pneumococcal infections Staphylococcus aureus Staphylococcus aureus - isolation & purification Staphylococcus infections Transplant Recipients Young Adult |
| title | A computer simulation model of the cost-effectiveness of routine Staphylococcus aureus screening and decolonization among lung and heart-lung transplant recipients |
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