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Tuesday, November 06, 2007

Veterans Hospitals Begin Universal Patient Screening for Resistant Bacteria

You've likely heard about the drug-resistant staph infection that's caused quite a stir in schools throughout the country this fall. Reacting to pressure from Medicare, this month the nation's VA Medical Centers will begin screening all patients for this and other difficult-(i.e., expensive)-to-treat conditions.

From Bloomberg:

Medicare, the U.S. health plan for the elderly and disabled, will stop paying for treatment of some infections that arise in hospitals and are caused by germs such as MRSA, or methicillin-resistant Staphylococcus aureus, that are invulnerable to existing medicines. Treating resistant infections can cost as much as $300,000 for each case.

MRSA, once found primarily in hospital patients, now is surfacing among other people. Hard-to-treat infections in U.S. hospitals cost an estimated $20 billion annually nationwide. Beginning this month, about 160 Veterans Affairs Medical Centers will screen patients for the bacteria. The risk of losing Medicare payments is spurring other facilities to test for the lethal germs as well.

In educational interest, article(s) quoted from extensively.


MRSA is found in about 4.6 percent of hospitalized patients, and now accounts for almost two-thirds of skin infections in emergency rooms, up from just 2 percent 35 years ago. About one in 20 patients hospitalized with the drug- resistant bacterium dies, according to government data published in July. Sales of antibiotics that work against MRSA infections will double over the next five years, to $2.5 billion, or 20 percent of the total market for antibiotics, according to New Brunswick, New Jersey-based drugmaker Johnson & Johnson.

The cost of caring for a post-surgical chest infection can range from a few thousand dollars to more than $250,000, according to an editorial published last month in the New England Journal of Medicine. Many hospitals are stepping up hygiene and hand-washing campaigns among doctors, nurses and other employees to combat the most common ways germs are spread. ...

Next October, Medicare will stop paying for chest infections after heart surgery and urinary tract infections that occur during a hospital stay. The U.S. health-care plan may also add bloodstream infections, which often occur in patients getting intravenous fluids, to the non-reimbursed list. Each bloodstream invasion can cost $4,000 for care.

The decision represents an added expense that many non-profit institutions, such as 450-bed Methodist Hospital in Minneapolis, can't afford to take on, said Leslie Baken, medical director of infection control for the facility.

It costs about $36,000 to treat most post-surgical chest infections while urinary tract infections can average $1,000. Buying MedMined's infection tracking system may cost the hospital about $120,000, she said.

Her hospital screens all patients for staph germs when they are admitted or transferred from one ward to another. U.S. Veterans Affairs Department hospitals are also starting a universal screening program for the germs, said Louis Rice, chief of the medical service at the Stokes VA Medical Center in Cleveland.

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