July 21, 2011
Another study documenting the costs and mortality associated with healthcare-associated infections (HAIs), this time with trauma patients.
The article from the Archives of Surgery looks at the impact of sepsis, pneumonia, Staphylococcus infections, and C. difficile-associated disease (CDAD) on mortality, length of stay, and inpatient costs. Here are some of the findings:
- Trauma patients who contract sepsis are six times more likely to die than those who don’t.
- Patients with HAIs other than sepsis have 1.5 1.9 greater odds of death, compared with patients who don’t contract HAIs.
- Inpatient costs associated with HAIs were 2.6 6 times greater than the costs of control patients, with pneumonia proving to be the most costly – $77,393 vs. $12,849 (control).
The study adds more fuel to the quality movement, which already has loads of evidence that HAIs are costly in terms of lives and hospital resources. They are also preventable. The authors put the study in the context of efforts to reduce adverse medical events:
Reducing HAIs is one of the top priorities in the efforts by the federal government and nongovernmental entities to improve patient safety and health care outcomes in the United States. In particular, the US Department of Health and Human Services has established a national agenda for HAI prevention in an Action Plan that outlines a strategy to reduce the incidence of HAIs by 75% over a 5-year period. Furthermore, in this action plan, methicillin-resistant Staphylococcus aureus and CDAD acquired in the acute hospital setting have been identified as priority areas. The National Quality Forum has identified the prevention of health care associated infections as a key area for improving patient safety in its list of Safe Practices for Better Healthcare.26 Three of the 6 recommended practices in the Institute for Healthcare Improvement s 100 000 Lives Campaign are focused on the prevention of HAIs. Mandatory public reporting of hospital HAI rates is becoming more widespread as part of the effort to increase transparency and accountability to achieve reductions in HAIs. Finally, the Centers for Medicare and Medicaid Services is no longer reimbursing hospitals for some HAIs as part of the legislatively mandated initiative to penalize hospitals for hospital-acquired conditions.
Importantly, and as a backdrop to these commitments, the shift towards more outcomes-based reimbursement schemes should help align incentives to tackle the HAI problem.
Image credit: Flickr: zoomar
