Economic Consequences of the Demography of MRSA Patients and the Impact of Broad-Spectrum Antimicrobials
Background: Studies have determined the societal impact of methicillin-resistant Staphylococcus aureus (MRSA) by modelling its impact on labour supply and productivity. In addition, most of the studies on the topic conclude that the problem of resistance should be counteracted on the macro level by reducing overall antibacterial consumption.
Objective: Two major questions have been raised in the present work. Firstly, is MRSA impairing labour supply and productivity? Secondly, is it the overall use of antibacterials that may be seen as crucial to the spread of MRSA infections?
Methods: The age distribution of MRSA patients is compared with the age distribution of the entire patient population at a German teaching hospital. In addition, the age distribution of MRSA patients was applied to the age distribution of the German population in the year 2050 in order to identify the effects of the double-ageing process on the spread of MRSA. Furthermore, recent epidemiological studies were reviewed on the impact of overall antibacterial consumption on MRSA infection rates.
Results: Based on available data, we show that patients infected or colonized with MRSA are, for the most part, beyond retirement age and thus not responsible for changes in labour supply or productivity. Application of age distribution of MRSA patients to the age distribution of the German population in the year 2050 gives a 24% increase in the number of MRSA cases to a total of 182 778 due to an ageing population. In addition, we show that a 32% reduction in the cost of MRSA to the German healthcare system could be reached if use of fluoroquinolones and third-generation cephalosporins was reduced by just 10% and, correspondingly, use of antiseptics for hand disinfection was increased by 10%.
Conclusions: MRSA is a phenomenon that, to a larger degree, affects the elderly population rather than the labour force. When it comes to policy options to counteract MRSA on the macro level, most economic research on the topic is biased in assuming that the overall use of antibacterials is responsible for the spread of MRSA infections.
KeywordsLabour Supply German Population German Hospital Hand Disinfection Attributable Cost
We would like to thank Deborah Lawrie-Blum for her help in preparing the manuscript. Furthermore, we thank the entire Division of Infection Control at University Medical Center Freiburg for efforts in data collection.
Research by Klaus Kaier on the economic impacts of antibiotic resistance is currently supported by the European Commission (Project IMPLEMENT, Project commissioned by DG Health and Consumers, Grant Agreement No. 20091107.
The authors have no conflicts of interest that are directly relevant to the content of this article.
CM and KK contributed equally to the development of the study to the calculation of results. In addition, KK was responsible for the preparation of the manuscript and acts as a guarantor for the overall content.
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