When adjusted for inflation, healthcare-associated infection (HAIs) in U.S. acute care hospitals cost $122 – $147 billion annually in direct and indirect costs. Such staggeringly large numbers can be difficult to comprehend, but in an era of tight margins and short staffing, it’s a mistake to neglect the fiscal impact of HAIs. Let’s take a closer look:
HAIs Increase Resource Use
On any given day, one in 31 hospital patients has an HAI, according to the U.S. Centers for Disease Control and Prevention. So, a 500-bed hospital may be treating 16 patients with HAIs at any given time.
Patients who develop central line-associated blood infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated drug-resistant pneumonia, or C. diff infections require additional blood tests, medications, imaging scans, and medical supplies. They may also require specialty care, such as an infectious disease consult, and increased monitoring or more intensive care.
Additional resources increase costs. In 2018, researchers found that it takes approximately $38,500 per patient to treat MRSA-associated pneumonia; in 2022 dollars, that’s nearly $45,000. Treating just 16 HAIs can cost a hospital well over half a million dollars.
HAIs increase Length of Stay
A patient who is admitted with heart failure but develops a catheter-associated urinary tract infection will almost inevitably stay in the hospital longer than a similar heart failure patient who does not develop a HAI. The average length of stay for a hospitalization in the U.S. is 5.5 days. The median length of stay for a hospitalized patient with a HAI is 28 days, according to a 2019 German study. A 2021 Scottish study estimates that a HAI extends a hospital stay by almost 8 days.
Patients who develop HAIs are also more likely to require readmission than other patients, tacking on additional hospital time. Extra days in the hospital increase costs, as patients require continued care.
HAIs Decrease Revenue Generation
Extended hospital stays typically do not generate additional income, despite the increased cost of care, because Medicare and some other health insurance companies do not reimburse for care associated with HAIs. The Centers of Medicare and Medicaid Services (CMS) also decrease overall payments to hospitals that rank in the worst-performing quartile of all hospitals on measures of hospital-acquired conditions.
Because patients with HAIs remain in the hospital longer than they otherwise would, they take up space that could instead be occupied by revenue-generating patients. Hospitals have an ethical responsibility to care for patients with HAIs but doing so almost always means foregoing income-generating opportunities to provide care at a loss.
Additionally, HAIs can sully a hospital’s reputation, causing consumers to choose other healthcare facilities to meet their medical needs. Families aren’t likely to seek care at the hospital where Grandma contracted an infection that landed her in an intensive care unit.
It’s More Cost-Effective to Prevent than Treat HAIs
It takes effort (and resources) to prevent HAIs. Excellent, evidence-based patient care, including regular hand hygiene, is the most effective way to prevent HAIs, and it typically costs more to provide top-notch care – which requires adequate staffing and sufficient resources – than it does to provide bare-bones care.
Research conducted at Stanford Hospital between October 2015 and October 2018 found that hospital costs increase $25,008 (approximately $29,500 in 2022 dollars) for each HAI prevented. However, preventing one HAI allows hospitals to admit an additional 4.62 patients, leading to a net gain. Hospital profits increase $582,464 ($687,000 in 2022 dollars) by preventing one HAI. The researchers concluded that “Although hospital cost appears to increase as HAIs are reduced, hospital profits rise even more.” This study suggests that it’s smart to invest in technology that’s been proven to increase hand hygiene and decrease HAIs. The up-front costs of an electronic hand hygiene system are well worth the significant return on investment. Fewer HAIs can increase profitability and boost your bottom line.
