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ICU infection prevention programs reduced costs, improved survival
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New data published in the American Journal of Infection Control suggest that infection control programs in ICUs are cost effective and improve survival among elderly patients with central line–associated bloodstream infections and/or ventilator-associated pneumonia.
Preventing central line–associated bloodstream infections (CLABSIs) in this population reduced ICU costs by almost $175,000 per patient, the researchers found. The cost reduction for preventing ventilator-associated pneumonia (VAP) was approximately $163,000.
“Any death from preventable infections is one too many,” Patricia W. Stone, PhD, RN, director of the Center for Health Policy at Columbia University School of Nursing, said in a press release. “We’ve known for decades what works to prevent infections and save lives. Now, our study shows just how much money can be saved by investing in prevention.”
Patricia Stone
Stone and colleagues used 5 years of Medicare data and data about health care–associated infection (HAI) rates and quality of life estimates from the CDC’s National Nosocomial Infection Surveillance system and the National Healthcare Safety Network. They created a model that included life-years, quality-adjusted life-years (QALYs) and health care expenditures for patients with and without CLABSIs and/or VAP. They also modeled the incremental cost-effectiveness ratios (ICERS) of HAI prevention programs.
Based on the model, implementing a multifaceted infection control program resulted in an increase of 15.55 life-years from the reduced risk for CLABSIs and 10.84 life-years from the reduced risk for VAP. The number of QALYs gained was 9.61 from the reduced risk for CLABSIs and 6.55 from the reduced risk for VAP. The ICERs of preventing VAP and CLABSIs were $14,250.74 per life-year gained and $23,277.86 per QALY gained.
In a sensitivity analysis, the researchers found the ICERs were highest, about $83,000 per QALY and $51,000 per life-year, if the intervention is effective in reducing only 10% of infections. If effective at reducing 90% of infections, the ICERs are about $22,000 per QALY and $13,000 per life-year.
“Although HAI rates have been reduced dramatically over the last decade, infections remain an ongoing problem, particularly emerging and resistant infections, such as those caused by multiple drug-resistant organisms,” the researchers wrote. “The social cost of these infections is high, as demonstrated by our model, and as a consequence, efforts to develop new prevention strategies are warranted.”
Disclosure: The researchers report no relevant financial disclosures.
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