Hospital-Acquired Infections Cost $10 Billion a Year: Study

Five most common health care-associated infections strike 440,000 U.S. patients each year

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Tuesday, September 3, 2013

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TUESDAY, Sept. 3 (HealthDay News) -- The five most common infections that patients get after they've been admitted to the hospital cost the U.S. health care system almost $10 billion a year, a new study shows.
One out of every 20 patients who are admitted to a hospital will fall victim to an infection they pick up while there, according to the U.S. Centers for Disease Control and Prevention. These infections can be serious and even life-threatening, and recent studies have estimated that as many as half of them may be preventable.
They are also expensive to treat. In 2006, in a bid to get hospitals to do more to prevent so-called health care-associated infections, Medicare stopped paying for patient care associated with certain serious health care-associated infections.
The new study from Harvard researchers, which was published online Sept. 2 in JAMA Internal Medicine, suggests that by focusing prevention efforts on surgical site infections, infections associated with the use of devices such as central lines, catheters and ventilators, and by guarding against infections caused by Clostridium difficile, hospitals could save substantial amounts of money.
"This is real money, I mean real money," said Dr. Trish Perl, a professor of medicine and pathology at the Johns Hopkins School of Public Health in Baltimore.
Perl recently completed a study of surgical site infections at four hospitals in the Johns Hopkins Health System. Her study concluded that if the hospitals could eliminate surgical site infections tied to the procedures they studied, they would see an increase in revenue of more than $2 million a year. She wasn't involved in the current research.
"Cost data like this is one of the tools we've got to get out there," Perl said.
To compile the new numbers, researchers conducted a meta-analysis, or a study of studies, to estimate the costs associated with each of the different kinds of infections. They used a large, national database maintained by the CDC to estimate the number of health care-associated infections. And they built mathematical models to incorporate variations in patient outcomes and to see how those variations impacted costs.
The study was funded by a donation promoting research on patient safety.
Central line-associated bloodstream infections averaged about $45,000 per case. Pneumonia infections that strike patients who are put on ventilators to help them breathe cost about $40,000 per case. The most common infections, surgical site infections, which happen in about one out of every 50 operations, cost around $21,000 each to treat. There are about four C. difficile infections for every 1,000 patients who spend a day in the hospital, making them the second most common kind of infection, and those cost about $11,000 each to treat. Urinary tract infections associated with the use of catheters cost about $900 each.
The researchers say their numbers probably underestimate the true cost of treating health care-associated infections.
"We're not including every sort of infection, but these five would account for the majority of infections every way you look at it," said Dr. Eyal Zimlichman, a research associate at the Center for Patient Safety at Brigham and Women's Hospital in Boston. "We're only looking at adults, we didn't take pediatric infections into account," he noted. They also limited their investigation to infections picked up in hospitals. They didn't factor in infections acquired in other kinds of health care settings such as nursing homes and dialysis clinics.
The narrow focus of the study, combined with progress made in reducing some kinds of infections, may help to explain why previous estimates of infection costs were higher, somewhere between $20 billion and $40 billion a year, the study authors pointed out.
There were also some surprises in the numbers.
Though many hospitals have substantially increased their efforts to prevent catheter-associated urinary tract infections, the new study found that while these infections are common, they account for less than 1 percent of all costs associated with health care-acquired infections.
"From a cost perspective, at least, one might suggest this isn't the first choice you want to put your emphasis on," Zimlichman said.

SOURCES: Trish Perl, M.D., professor, medicine and pathology, Johns Hopkins School of Public Health, Baltimore; Eyal Zimlichman, M.D., research associate, The Center for Patient Safety, Brigham and Women's Hospital, Boston; Sept. 2, 2013, JAMA Internal Medicine, online

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