“This might be achieved by increasing federal support to evaluate effectiveness of (healthcare-associated infection) prevention approaches, encouraging innovation to expand the list of effective interventions or enhancing surveillance programs to include post discharge tracking of SSIs,” the authors wrote. Financial incentives, such as policies to prevent payment for surgical site infections, may also be effective, though policies should be studied for potential unintended consequences.
Zimlichman, in an interview, said the evidence is less clear on the best interventions to prevent surgical-site infections. Better monitoring of the harmful infections would help identify potential interventions and provide a more accurate estimate of surgical site infection prevalence, he said.
Central-line associated bloodstream infections, which the Centers for Disease Control and Prevention estimate total 41,000 annually, ranked as the most costly, at $45,814 per case, the study said. When infections involved drug-resistant bacteria, the cost soared another 27%, to $58,614, and patients were likely to be hospitalized an additional 15.7 days compared with those who did not suffer a healthcare-associated infection.
Central-line bloodstream infections accounted for nearly 19% of estimated total annual cost of avoidable infections included in the study.
Ventilator-associated pneumonia, surgical site infections and Clostridium difficile infections cost an estimated $40,144, $20,785 and $11,285 per case, respectively.
The least costly infection, on a per-case basis, was catheter-associated urinary-tract infections, which totaled $896.
Surgical site infections were the most common and accounted for slightly more than one-third of the total annual costs. The authors called for additional research and new public policy to boost surgical site infection prevention.
The study relied on the CDC and research studies for recent data on the prevalence of the preventable infections. Researchers combed through studies published in the last quarter century for data on the cost and length of hospital stays for patients with the avoidable infections to calculate the estimates.
Prior estimates put the estimated cost as high as $40 billion. Progress fighting the infections has reduced the cost, the authors said, but the newly published study also limited its findings to five types of healthcare-associated infections for adults who were hospitalized.
"The numbers are still staggering," said Zimlichman, despite evidence that suggests some progress reducing avoidable infections. "They're still hard to comprehend."
Follow Melanie Evans on Twitter: @MHmevans
