Better risk management could cut MRSA infection rates

April 26, 2007

The larger -- and busier -- an NHS hospital is, the higher the MRSA infection rate, research from the Nottingham University Business School has revealed.

The impact of risk management standards on the frequency of MRSA infections in NHS hospitals study looked at how demanding risk management standards imposed by hospital insurers -- and the premium discounts offered if these rigorous standards are met -- could reduce MRSA infection rates.

Institutions with the highest number of 'bed days' for riskier treatments, particularly surgery and gynaecology, have an increased likelihood of infection. But financial incentives could play a role in controlling MRSA infection rates, potentially slashing the incidence of infection by between 11 and 20 per cent, the study shows.

MRSA infection costs the NHS £1bn a year in terms of prevention, compensation payments and additional treatment. Deaths involving MRSA rose from 51 in 1993 to 1,629 in 2005.

All NHS hospitals carry insurance to cover them against claims for illness and injuries caused by medical treatment. As with other insurance settings, the cover it provides reduces the need to try to minimise exposure to claims, because the insurer, not the hospital, will be paying the claim. In the NHS, the insurer, the NHS Litigation Authority (NHSLA), overcomes this problem by outlining strict risk management standards. The standards are increasingly demanding and -- if they can demonstrate compliance with them -- hospitals are granted increasing discounts on the premiums they pay the NHSLA for their cover. If the financial incentives implicit in these arrangements are effective, hospitals attaining higher risk management levels could face lower MRSA infection rates

The study, led by Paul Fenn, Norwich Union Professor of Insurance Studies in the Nottingham University Business School, involved Professor Alastair Gray from the University of Oxford and Professor Neil Rickman from the University of Surrey. The team looked at data from all NHS hospitals in the UK between 2001 and 2005, including MRSA infection rates, hospital size and mix of cases, bed utilisation rates and risk management levels. They found that the introduction of higher risk management standards, including hand hygiene and infection control measures, reduced the incidence of infection in hospitals by between 11 and 20 per cent after allowing for all other variations in infection rates.

Larger hospitals were found to have higher infection rates, particularly those with higher proportions of patients undergoing surgical or gynaecological treatment. And the "busier" the hospital -- the closer it is to full capacity -- the higher the incidence of MRSA infection.

Professor Fenn said: "Our research has demonstrated that hospital management has responded to financial incentives by adopting higher risk management standards, and where this happens, patient safety tends to improve."
-end-
Notes to editors: The University of Nottingham is Britain's University of the Year (The Times Higher Awards 2006). It undertakes world-changing research, provides innovative teaching and a student experience of the highest quality. Ranked by Newsweek in the world's Top 75 universities, its academics have won two Nobel Prizes since 2003. The University is an international institution with campuses in the United Kingdom, Malaysia and China.

More information is available from Sophia Taylor at the Nottingham University Business School on +44 (0)115 846 6974, sophia.taylor@nottingham.ac.uk or Tara de Cozar, Internal Communications and Media Relations Officer in the Public Affairs Office at The University of Nottingham, on +44 (0)115 846 8545, tara.decozar@nottingham.ac.uk

University of Nottingham

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