Bloodstream Infection in the Intensive Care Unit: Preventable Adverse Events and Cost Savings

Area of Science:

• Healthcare Economics
• Infectious Disease Prevention
• Critical Care Medicine

Background:

• Central line-associated bloodstream infections (CLABSIs) represent a major economic burden in adult intensive care units (AICUs).
• Quantifying the excess length of stay and associated costs of CLABSIs is crucial for resource allocation and healthcare policy.

Purpose of the Study:

• To evaluate the additional length of stay (LOS) and incremental costs linked to CLABSIs in AICU patients.
• To provide data supporting the economic rationale for CLABSI prevention strategies.

Main Methods:

• A case-control study design was employed, matching 30 CLABSI cases with 30 controls admitted to the AICU between 2006-2009.
• Matching criteria ensured comparability between groups, excluding confounding factors influencing cost and care.
• Length of stay (AICU and total hospital) and incremental costs were meticulously measured and calculated for each matched pair.

Main Results:

• CLABSI episodes were associated with an average increase of 10.5 days in AICU and 9.1 days post-AICU, totaling 19.6 additional days of hospitalization.
• The incremental cost per CLABSI episode was substantial, amounting to $65,993 within the AICU and $23,893 after AICU discharge, for a total of $89,886.
• These findings highlight the significant financial impact of CLABSIs on healthcare systems.

Conclusions:

• Preventing CLABSIs can lead to considerable cost savings for payers, offsetting revenue losses for providers.
• Incentivizing providers through shared financial gains from prevention can encourage sustained investment in CLABSI reduction measures.
• Ultimately, reducing CLABSIs enhances patient safety and decreases their risk of developing these severe infections.