Major articleMulticenter study of health care cost of patients admitted to hospital with Staphylococcus aureus bacteremia: Impact of length of stay and intensity of care

•We analyzed hospital costs of adults admitted for Staphylococcus aureus bacteremia at 4 sites.•We used standardized methodology to determine direct costs of care per case.•Patients with methicillin-resistant Staphylococcus aureus had 1.3 times higher costs than patients with methicillin-susceptible S aureus bacteremia.•Human health resources comprised 70% of total costs per case; antibiotics comprised 1%-2%.•Length of stay and care intensity should be the major focus of any resource assessment exercise.

BackgroundMethicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant S aureus bacteremia (SAB) have both been associated with high morbidity and mortality and heavy consumption of health care resources. We compared clinical and economic data for hospitalized cases of SAB in the context of a publicly funded health care system.MethodsA cost analysis was undertaken on an adult cohort of patients from 4 hospitals with SAB diagnosed within 3 days of hospitalization. Primary outcome was direct cost of inpatient care per case, determined at discharge and itemized using a standardized methodology.ResultsA total of 435 patients were admitted with SAB; 58 had methicillin-resistant S aureus (MRSA). The median length of stay was similar in patients with MRSA and MSSA. There was no significant difference between the groups for mortality. Median direct medical costs of SAB were $12,078. Patients with MRSA had 1.32 times higher direct costs than MSSA. A similar estimate was derived using a propensity score approach (P = .148). Human health care resources comprised >70% of total costs per case, whereas antibiotics comprised 1%-2%.ConclusionUnderstanding the dynamics of resource consumption is critical to improving its efficiency and the quality of patient care. Our findings suggest that hospital length of stay and care intensity should be the major focus of any resource assessment exercise.