Data reporting the costs of treating hospital-acquired infection shows why it’s crucial for hospitals to practice preventative infection control not only for the sake of its patients, but for its bottom line.
Infection in a hospital is costly on a number of levels. From a patient perspective, infections can cause severe complications, pain, and even death. For the hospital, the cost of treatment for hospital-acquired infections (HAI) can be a tremendous burden.
According to the Center For Disease Control, healthcare-associated infections account for an estimated 1.7 million infections and 99,000 associated deaths each year. Of these infections:
- 32 percent of all healthcare-associated infection are urinary tract infections
- 22 percent are surgical site infections
- 15 percent are pneumonia (lung infections)
- 14 percent are bloodstream infections
In a paper available via the Center For Disease Control in March 2009, economist R. Douglas Scott II reports an HAI occurs in 4.5 of every 100 hospital admissions. In the paper, Scott applied two different Consumer Price Index (CPI) adjustments to account for the rate of inflation in hospital resources and reports an overall annual direct medical cost of HAI to U.S. hospital ranging from $28.4 to $33.8 billion after adjusting for all urban consumers, and $35.7 to $45 billion after adjusting for inpatient hospital services.
The paper suggests the benefits of prevention range from a low of $5.7 billion to $6.8 billion with 20 percent of infections preventable for all consumers to a high of $25 to $31.5 billion with 70 percent of infections preventable for inpatient hospital services.
With the shift in billing procedures from Medicare & Medicaid Services (CMS) that took effect in October 2008, costs associated with hospital-acquired infections are not reimbursed by CMS, leaving hospitals completely responsible for the costs. The reason for this change: infections are largely preventable, and studies have shown the costs of investing in preventative approaches outweigh the cost of paying for treatment of an infection in the hospital should it occur.
Take, for example, the risk of Catheter-Related Bloodstream Infections (CRBSI). More than 5 million central venous catheters (CVC) are inserted annually into hospital patients in the U.S. According to a 2003 study, more than 15 percent of patients who receive these catheters experience complications with infectious complications occurring 5 to 26 percent. The CDC reports an estimated 30,000 patients die each year from these infections.
Costs associated with treating CRBSI can be a tremendous burden for hospitals. The CDC reports the average cost for treating such an infection ranges from $34,508 to $56,000 each.
Studies have show that the use of central venous catheters impregnated with either minocycline and rifampin or chlorhexidine and silver sulfadiazine reduces the rates of catheter colonization and catheter-related bloodstream infection as compared with the use of unimpregnated catheters, and research suggest using these catheters should be considered in all circumstances.
What’s more, studies have shown using preventative, impregnated catheters is a cost-effective preventative approach to infections in the hospital. Research shows when the institutional rate of catheter-related bloodstream infections is higher than a mere 2 percent, investing in and using chlorhexidine-and-silver-sulfadiazine–impregnated catheters may reduce overall costs.
The number one goal for all surgical professionals and hospitals is, and should be, to take care of all patients at the highest level. That in itself is an incentive to employ infection control measures. However, cost-control is an important issue all hospitals face, as well. With rising treatment costs, hospitals must be aware of what will be a cost-effective approach to prevention, so it can keep its patients safe, as well as its business running efficiently.
Preventing Complications of Central Venous Catheterization
David C. McGee, M.D., and Michael K. Gould, M.D.
Volume 348:1123-1133 March 20, 2003 Number 12
New England Journal Of Medicine
The Direct Medical costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention
R. Douglas Scott II, Economist Division of Healthcare Quality Promotion National Center for Preparedness, Detection, and Control of Infectious Diseases Coordinating Center for Infectious Diseases Centers for Disease Control and Prevention March 2009
Centers For Disease Control And Prevention
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