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-resistant Staphylococcus 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