Posted on June 4, 2015
In some hospitals, infection prevention relies on manual review of paper reports or spreadsheets created by an infection preventionist’s retrieval of data from several information systems. Administrators may often assume that this structure minimizes the costs of the infection prevention program. But this structure does not, however, take into account the increased costs associated with education and training of staff, and timely interventions targeted to eliminate healthcare associated infections.
Hospitals that have implemented high-performing infection prevention and control (IPC) programs supported by electronic surveillance systems have seen rates of certain healthcare-associated infections (HAIs) drop by as much as 68%. These programs aggregate and analyze data from across the hospital in real time to identify at-risk patients in hours—or days— long before a manual review would be able to produce the same results, enabling appropriate treatment to begin sooner, improving patient outcomes while saving lives.
Inadequate surveillance, on the other hand, can substantially increases costs associated with HAIs. Researchers estimate that central line-associated bloodstream infections are the most expensive HAIs, at an average cost of $45,814 per infection. Ventilator-associated pneumonia followed at $40,144 and surgical site infections at $20,785 each. Clostridium difficile infections cost hospitals $11,285 per instance, while each catheter-associated urinary tract infection runs $896.1
These five types of HAIs alone cost hospitals $9.8 billion annually, and the Centers for Disease Control and Prevention (CDC) estimates that the total cost of HAIs national is between $35.7 and $45 billion each year.
The costs of these infections are largely borne by hospitals as many insurers and the Centers for Medicare and Medicaid Services (CMS) have instituted policies that prohibit payment for some of the most common and preventable HAIs (e.g. central line associated bloodstream infections and catheter associated urinary tract infections that occur in the ICU) to keep with increased emphasis on value-based payment and patient safety.
The burden of HAIs could be dramatically reduced if all hospitals implemented high-performing IPC programs. With an estimated reduction in HAIs associated with robust infection prevention programs that are supported by automated surveillance, the total cost of HAIs in the U.S. could drop by $25-$31.5 billion.2
On an individual hospital basis, the savings associated with a high-performing IPC can add up significantly, as well. Previous estimates put the current cost of HAIs at about $27,500 per bed per year, money that hospitals would not want to leave on the table.3 That number does not include the reimbursement penalties levied by Medicare and other payers for high rates of healthcare-associated infections, which more than 1 in 7 hospitals experienced in 2014. As of this year, hospitals have up to 5% of their total Medicare reimbursements at risk on top of the direct cost of HAIs.
Given the total costs associated with inadequate surveillance and an underpowered infection prevention and control program, hospitals may often find that better resourced and more robust IPC programs can actually save them money by recouping the cost of the system in just a few months post-implementation.
How has your hospital reduced costs associated with HAIs? Have you seen a drop in costs as surveillance improved?
1. Zimlichman E, Henderson D, Tamir O, Franz C, Song P, Yamin CK, Keohane C, Denham CR, Bates DW. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med. 2013 Dec 9-23;173(22):2039-46.
2. Scott RD. The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention. CDC. March 2009.
3. Snydor ERM, Perl TM. Hospital Epidemiology and Infection Control in Acute-Care Settings. Clin Microbiol Rev. 2011 January;24(1):141-173.