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Letters
August 6, 2008

Universal Screening for Methicillin-Resistant Staphylococcus aureus by Hospitals

JAMA. 2008;300(5):503-506. doi:10.1001/jama.300.5.503-a

To the Editor: In their cohort study of universal screening for methicillin-resistant Staphylococcus aureus (MRSA), Dr Harbarth and colleagues1 stated that the intervention was not cost-beneficial from a hospital standpoint. Proposed new rules from the Centers for Medicare & Medicaid Services starting October 1, 2008, would no longer reimburse hospitals or clinicians for certain medical errors, including several categories of hospital-acquired infection.2 I believe that the newfound zeal of US hospitals to screen high-risk patients on admission for MRSA reflects an attempt to mitigate payment reduction or diagnosis-related group reduction for acquired infections by proving that the patient was already infected or at least colonized at the time of admission. These patients can then be isolated and perhaps warrant a higher billing rate based on complexity. Achieving lower infection rates is a laudable goal, but maintaining reimbursement may be the force driving much of this initiative in for-profit hospitals, which could make this intervention cost-beneficial from their perspective.

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