According to the Agency for Healthcare Research and Quality (AHRQ), the United States Congress allocated $34 million for projects by that agency to contain healthcare-associated infections (HAIs). These are infections that patients develop while being treated for another condition and are rampant by current estimates, accounting for one of the top ten causes of death in this country.
Financially, the burden is overwhelming, representing $28 to 33 billion additional healthcare costs annually, according to the CDC. In Pennsylvania, CHOP and the University of Pennsylvania are participating in two of the 22 projects begun by a multi-agency cooperative effort.
Changing the course at the provider level, however, can be daunting for a number of reasons. First, the cost-benefit of doing so may not be readily apparent. Second, according to the September 2010 Pennsylvania Patient Safety Advisory in “Demonstrating Return on Investment for Infection Prevention and Control”, entities may be ill-equipped to estimate the real institutional cost. The Safety Authority also notes that there may be an expectation that HAIs are part and parcel of the risk of doing business with older/sicker patients or that reimbursement covers the additional costs.
Challenging these myths merely requires a look at Pennsylvania’s Health Care Cost Containment Council’s 2007 report cited by the Safety Authority. The average hospital stay in Pennsylvania was 4.4 days for a total of $35,168. When an HAI event occurs, this average skyrockets to $191,872 with an average stay of 19.7 days.
The CDC estimated that 70% of infections could have been prevented through infection control programs that include appropriate staffing levels, education, isolation and outbreak programs and an organization that encourages safety.
In its article, the Authority refers to the intangible costs of HAIs, pointing out such costs as permanent disability and lost wages. This does not come close to describing the human toll on patients who are recovering from the aftermath of an HAI, such as disfigurement, depression and lengthy immobility; all of which are consequences of an unrelated medical procedure.