REAL-WORLD HEALTHCARE RESOURCE UTILIZATION AND COSTS OF HOSPITAL-ONSET METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS NON-VENTILATOR-ASSOCIATED PNEUMONIA IN U.S. HOSPITALS: 2023-2025
Author(s)
Chendi Cui, PhD, MS, MBBS , Laura Curry, MS, PhD, Ning An Rosenthal, MPH, PhD, MD.
Premier Applied Sciences, Premier, Inc., Charlotte, NC, USA.
Premier Applied Sciences, Premier, Inc., Charlotte, NC, USA.
OBJECTIVES: Hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) non-ventilator-associated pneumonia (NVAP) represents a serious clinical challenge and imposes considerable economic burden. Recent evidence on healthcare resource utilization (HCRU) and costs for these infections is limited. This study assessed real-world HCRU, costs, and clinical outcomes associated with hospital-onset MRSA NVAP in the U.S.
METHODS: We conducted a retrospective cohort analysis using the Premier Healthcare Database. Hospitalizations of adult patients (≥18 years) with microbiologically confirmed hospital-onset MRSA NVAP who were discharged between January 1, 2023, and June 30, 2025, were included. HCRU, including length of stay (LOS), ICU utilization, in-hospital mortality, and 180-day readmissions, and costs for index hospitalization and follow-up were reported.
RESULTS: A total of 1,103 hospitalizations met inclusion criteria. Median LOS was 15 days (IQR: 8-32), and median index hospitalization cost was $52,013 (IQR: $23,625-$123,650). ICU admission occurred in 63.7% of patients, with a median ICU LOS of 10 days (IQR: 4-19) and median ICU cost of $67,182 (IQR: $29,098-$134,225). In-hospital mortality was 33.7%. Of those surviving the index hospitalization (n=901), within 180 days of discharge, 53.6% (n=483) had all-cause readmissions, and 26.1% (n=235) had NVAP-related readmissions. Median time to first readmission was 27 days (IQR: 12-63). The cumulative 180-day cost for all-cause readmissions was $40,898 (IQR: $19,166-$86,417) among those with any readmission in that period.
CONCLUSIONS: Hospital-onset MRSA NVAP imposes a considerable clinical and economic burden, characterized by extended hospital stays, ICU utilization, and high mortality. The substantial costs associated with both initial infection and subsequent readmissions highlight the need for more effective infection control measures and improved treatment and discharge planning. Strategies aimed at reducing recurrence and optimizing care pathways could significantly mitigate resource use and improve patient outcomes.
METHODS: We conducted a retrospective cohort analysis using the Premier Healthcare Database. Hospitalizations of adult patients (≥18 years) with microbiologically confirmed hospital-onset MRSA NVAP who were discharged between January 1, 2023, and June 30, 2025, were included. HCRU, including length of stay (LOS), ICU utilization, in-hospital mortality, and 180-day readmissions, and costs for index hospitalization and follow-up were reported.
RESULTS: A total of 1,103 hospitalizations met inclusion criteria. Median LOS was 15 days (IQR: 8-32), and median index hospitalization cost was $52,013 (IQR: $23,625-$123,650). ICU admission occurred in 63.7% of patients, with a median ICU LOS of 10 days (IQR: 4-19) and median ICU cost of $67,182 (IQR: $29,098-$134,225). In-hospital mortality was 33.7%. Of those surviving the index hospitalization (n=901), within 180 days of discharge, 53.6% (n=483) had all-cause readmissions, and 26.1% (n=235) had NVAP-related readmissions. Median time to first readmission was 27 days (IQR: 12-63). The cumulative 180-day cost for all-cause readmissions was $40,898 (IQR: $19,166-$86,417) among those with any readmission in that period.
CONCLUSIONS: Hospital-onset MRSA NVAP imposes a considerable clinical and economic burden, characterized by extended hospital stays, ICU utilization, and high mortality. The substantial costs associated with both initial infection and subsequent readmissions highlight the need for more effective infection control measures and improved treatment and discharge planning. Strategies aimed at reducing recurrence and optimizing care pathways could significantly mitigate resource use and improve patient outcomes.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
P53
Topic
Epidemiology & Public Health
Disease
SDC: Infectious Disease (non-vaccine)