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SSIs, VAP constitute bulk of annual HAI costs
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The annual cost for the five major health care-associated infections, or HAIs, was nearly $10 billion for an estimated 440,000 infections, according to research findings published in JAMA Internal Medicine.
According to Eyal Zimlichman, MD, MSc, of the Center for Patient Safety Research and Practice at Brigham & Women’s Hospital, past estimates were in the range of $20 billion to $40 billion annually, for an estimated 1.7 million HAIs.
Eyal Zimlichman
“Although we only included the five major HAIs for adults only and for acute care facilities, we still believe our estimate represents a significant decrease in HAI incidence and cost,” Zimlichman told Infectious Disease News. “We attribute that to policy changes that are slowly transferring the risk from payers to providers, thus providing an incentive to implement processes that would prevent HAIs.”
Surgical site infections (SSIs) and ventilator-associated pneumonia (VAP) had the highest costs, constituting 33.7% and 31.6% of the total, respectively. The remaining infections included central line–associated bloodstream infections (CLABSIs), Clostridium difficile infections and catheter-associated urinary tract infections, which made up 18.9%, 15.4% and less than 1% of the cost, respectively.
The researchers estimated the costs and length of hospital stay attributed to the five infections by conducting a systematic review of 26 studies published from 1986 to April 2013. They determined incidence estimates using data from the CDC’s National Healthcare Safety Network. With this information, they estimated the annual cost of the infections.
The most expensive infections, on a per case basis, were CLABSIs, which cost $45,814 per case. When the CLABSIs were caused by methicillin-resistant Staphylococcus aureus, the cost per case was $58,614. SSIs cost $20,785 per case, which more than doubled to $42,300 when the cause was MRSA. VAP infections cost $40,144 per case, C. difficile infections cost $11,285 per case and catheter-associated urinary tract infections cost $896 per case.
“Overall, this is positive news, but much more needs to be done, specifically on several of the HAIs, like SSIs, which account for more than a third of all HAI-related costs,” Zimlichman said. “More research is needed that would look for effective interventions. Better surveillance programs are needed that would track postoperative patients and record development of SSIs and provide hospitals with these data.”
Zimlichman said that these data may encourage hospitals to invest more in initiatives to drive HAI numbers down. They also may encourage policy makers to increase and hasten emerging payment reforms and non-payment policies that would continue to push the financial risk to the providers, he said.
In the future, Zimlichman said he would like to break down the data by state to compare local policy and incentives with actual data on HAI incidence.
Eyal Zimlichman, MD, MSc, can be reached at ezimlichman@partners.org.
Disclosure: Zimlichman reports no financial disclosures.
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