By itself, a central line-associated bloodstream infection (CLABSI) is the most expensive healthcare-associated infection, costing $45,814 each and requiring a 10.4-day length of stay, 6.9 of them in the intensive care unit the researchers found. That's much higher than the per infection cost of an SSI, which is about $20,785. But if the CLABSI is from methicillin-resistant staphylococcus aureus, the cost per CLABSI goes up about $13,000 per infection, the report said.
Zimlichman and his colleagues performed a literature search of studies between 1986 and 2013 to estimate the costs of treating these infections, saying that even though experts have proof that they can reduce these infections dramatically, many hospital leaders may not justify a prevention expense because until recently, public policy penalties have been extremely limited.
Under authority of the Deficit Reduction Act of 2005, the Centers for Medicare & Medicaid Services stopped paying for extra care required for eight types of hospital-acquired conditions, starting Oct. 1, 2008. But that has resulted in paltry federal savings, estimated at no more than about $20 million a year, because most of these patients are so sick, they receive outlier diagnostic group billing code.
Other incentives in payment policy are looming, Zimlichman acknowledges.
Under the Patient Protection and Affordable Care Act, the value-based purchasing incentive payment will soon include a CLABSI measure in the algorithm, joined in another one or two years by catheter-associated urinary tract infections.
Starting Oct. 1, 2014, a 1% penalty will penalize hospitals with the highest rates of preventable infections, and rates of CAUTI and CLABSI account for 50% of the score.