Healthcare-Associated Infection Costs Detailed

Cheryl Clark, for HealthLeaders Media , September 3, 2013

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.

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3 comments on "Healthcare-Associated Infection Costs Detailed"

Richard Weinberg MD (9/9/2013 at 3:25 PM)
Dr. Angel's frustration is easily understood but he misstates the reasoning behind the quality improvement process and the financial penalties to which he refers. The penaities are not designed to be levied on every post op infection; rather, they are designed to be levied on hospitals and surgeons whose infection rates are much higher than the "norm." The wide variation in these rates, which are risk and severity adjusted, is well documented and the CMS programs are designed to get the high-infection-rate institutions and physicians to do better.

Jeff Angel, M. D. (9/4/2013 at 6:43 PM)
Interesting article. Again, putting all the blame on hospitals and surgeons. Wow, why don't we get rid of hosptials and surgeons. Problem solved and save all those calculated dollars. Seriously, much work has been done by hospitals and doctors, but switching to a system that penalizes any infection with not paying someone for 5 days(that is what some of the extreme measures state) or shutting down hospitals, does that really help population? Sometimes, a surgical site infection is going to be 15%, no matter what...does that mean no one is going to do a great surgery, because of an expected infection rate????????????? What about the non-compliant patient[INVALID]refuse life-saving surgery or repairing a shattered femur after car wreck, because if it becomes infected or dvt occur because they smoke, have diabetes, cancer, or some other illness[INVALID][INVALID]-I'M responsible!!?????? Articles like this are sickening to surgeons[INVALID][INVALID]we are doing every swab, hibiclens, stratifying patient, etc we CAN DO!!!!!!!!!!! SURGEONS ARE NOT PROBLEM!!!! Why not run some counter articles. Sickening to see one side constantly!!!!!!!!!!! Dock my pay for expected rate of complications and cut my pay to near zero....who is going to take care of your shattered femur?

PRD (9/4/2013 at 1:40 PM)
I think you meant ventilator- a ssosciated RESPIRATORY tract infections.




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