Volume 53 | Number S3 | December 2018

Abstract List

Richard E. Nelson Ph.D., Makoto Jones M.D., Chuan‐Fen Liu M.P.H., Ph.D., Matthew H. Samore M.D., Martin E. Evans M.D., Vanessa W. Stevens Ph.D., Thomas Reese Pharm.D., Michael A. Rubin M.D., Ph.D.


To measure how much of the postdischarge cost and utilization attributable to methicillin‐resistant () health care‐associated infections (s) occur within the Department of Veterans Affairs () system and how much occurs outside.

Data Sources/Study Setting

Health care encounters from 3 different settings and payment models: (1) within the ; (2) outside the but paid for by the (purchased care); and (3) outside the and paid for by Medicare.

Study Design

Historical cohort study using data from admissions to hospitals between 2007 and 2012.


We assessed the impact of a positive test result on costs and utilization during the 365 days following discharge using inverse probability of treatment weights to balance covariates.

Principal Findings

Among a cohort of 152,687 hospitalized Veterans, a positive test result was associated with an overall increase of 6.6 (95 percent : 5.7–7.5) inpatient days and $9,237 (95 percent : $8,211–$10,262) during the postdischarge period. inpatient admissions, Medicare reimbursements, and purchased care payments accounted for 60.6 percent, 22.5 percent, and 16.9 percent of these inpatient costs.


While most of the excess postdischarge health care costs associated with s occurred in the , non‐ costs make up an important subset of the overall burden.