Overcrowding driving worldwide MRSA rates
Tuesday, 24 Jun 2008 10:02
Overcrowding on hospital wards has increased MRSA rates, report says
Overcrowding and understaffing in hospitals worldwide are increasing rates of the healthcare-acquired infection MRSA, a report has warned today.
Researchers in Australia say the drive towards efficiency has placed high levels of stress on healthcare systems with unwelcome side effects.
Writing in the journal Lancet Infectious Diseases, they argue that this drive has created a vicious cycle.
As overcrowding and understaffing increase MRSA rates, this leads to increased inpatient hospital stay, bed blocking and further infection control failure.
The study's authors point to Australia, where there has been a 40 per cent decrease in hospital beds per head but a 20 per cent increase in patient throughput between 1982 and 2000.
They argue that restructuring in the UK, Canada, the US and Netherlands has resulted in fewer patients being dealt with as inpatients and more as outpatients.
In Britain higher patient admission rates together with bed reductions have led to 71 per cent of health trusts exceeding the government target bed occupancy of 82 per cent.
"In such stressed, high-throughput systems, periodic overcrowding (high bed occupancy rate) and understaffing (low health-care worker to patient ratio) are inevitable because the system has limited capacity to scale according to fluctuations in patient admissions, available resources (such as numbers of staff), and other challenges," the researchers write.
They warn that the situation is likely to be made worse by ageing populations in high-income countries and growth of populations.
The study concludes that effects on patient safety should be taken into account when change is proposed to healthcare systems.
"There is an urgent need for detailed study of the relative effects of acute short-term and chronic long-term resource constraints on the dynamics of MRSA infection and a concurrent requirement for developing resource allocation strategies that minimise MRSA transmission without compromising the quality and level of patient care," the researchers write.
"We suggest that future control programme evaluations explicitly consider available infrastructure and staffing resources so that recommendations arising from the evaluation can be applied to real-world settings."