Hospital-acquired infections added $8.1M in costs in 2006

Bernie Monegain, Editor, Healthcare IT News

Hospital-acquired infections killed 48,000 people and added $8.1 million to healthcare costs in 2006, according to a study published Monday in the Archives of Internal Medicine.

HAIs can be prevented by hand-washing, and healthcare organizations have employed information technology to help fight HAIs by better tracking and benchmarking.

The Department of Health and Human Services unveiled a plan in January 2009 that includes healthcare information technology as a critical piece in preventing healthcare-associated infections (HAIs). The plan establishes a set of five-year national prevention targets to reduce and possibly eliminate HAIs.

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The authors of the new HAI study say it is the largest nationally representative study to date of the toll taken by sepsis and pneumonia, two conditions often caused by deadly microbes, including the antibiotic-resistant bacteria MRSA. Such infections can lead to longer hospital stays, serious complications and even death.

"In many cases, these conditions could have been avoided with better infection control in hospitals," said Ramanan Laxminarayan, principal investigator for Extending the Cure, a project examining antibiotic resistance based at the Washington, D.C. think-tank Resources for the Future.

"Infections that are acquired during the course of a hospital stay cost the United States a staggering amount in terms of lives lost and healthcare costs," he said. "Hospitals and other healthcare providers must act now to protect patients from this growing menace."

69 million records analyzed

Laxminarayan and his colleagues analyzed 69 million discharge records from hospitals in 40 states and identified two conditions caused by healthcare-associated infections: sepsis, a potentially lethal systemic response to infection, and pneumonia.

The researchers looked at infections that developed after hospitalization. They zeroed in on infections that are often preventable, like a serious bloodstream infection that occurs because of a lapse in sterile technique during surgery, and discovered that the cost of such infections can be quite high. For example, people who developed sepsis after surgery stayed in the hospital 11 days longer, and the infections cost an extra $33,000 to treat per person.

The team found that nearly 20 percent of people who developed sepsis after surgery died as a result of the infection.

"That's the tragedy of such cases," said Anup Malani, a study co-author, investigator at Extending the Cure and professor at the University of Chicago. "In some cases, relatively healthy people check into the hospital for routine surgery. They develop sepsis because of a lapse in infection control – and they can die."

The team also looked at pneumonia, which can occur if a disease-causing microbe gets into the lungs – in some cases when a dirty ventilator tube is used. They found that people who developed pneumonia after surgery, which is also thought to be preventable, stayed in the hospital an extra 14 days. Such cases cost an extra $46,000 per person to treat. In 11 percent of the cases, the patient died as a result of the pneumonia infection.

According to the authors, HAIs frequently are caused by microbes that defy treatment with common antibiotics. "These superbugs are increasingly difficult to treat and, in some cases, trigger infections that ultimately cause the body's organs to shut down," said Malani.

In 2002, the Centers for Disease Control and Prevention estimated that HAIs are associated with 99,000 deaths per year. While the Extending the Cure study looked at two of the most common and serious conditions caused by these infections, it also calculated deaths actually caused by, rather than just associated with, infections patients get in the hospital.

Based on their research, study authors were able to estimate the annual number of deaths and healthcare costs due to sepsis and pneumonia that is actually preventable.

"The nation urgently needs a comprehensive approach to reduce the risk posed by these deadly infections," Malani said. "Improving infection control is a clear way to both improve patient outcomes and lower healthcare costs."

The study was supported by the Robert Wood Johnson Foundation's Pioneer Portfolio, which funds innovative ideas that may lead to breakthroughs in the future of health and healthcare.