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Cost of Health Care-Associated Infections in the United States
Joseph D Forrester1, Paul M Maggio, Lakshika Tennakoon
1From the Division of General Surgery, Department of Surgery, Stanford University, Stanford, California.
Insights
Health care-associated infections (HAIs) cost the U.S. billions annually. Clostridioides difficile infections and surgical site infections were the most frequent and costly HAIs in 2016.
Area of Science:
- Healthcare Economics
- Infectious Disease Epidemiology
- Public Health
Background:
- Health care-associated infections (HAIs) represent a significant financial burden on healthcare systems.
- Existing national cost estimates for HAIs are outdated, necessitating updated analyses.
- Understanding the economic impact of specific HAIs is crucial for targeted prevention strategies.
Purpose of the Study:
- To provide updated national cost estimates for HAIs in the United States.
- To identify the most prevalent and costly types of HAIs.
- To analyze the economic burden of specific HAIs, including Clostridioides difficile infection (CDI) and surgical site infections (SSIs).
Main Methods:
- Retrospective analysis of the 2016 National Inpatient Sample, a comprehensive U.S. inpatient database.
- Inclusion of inpatient encounters with International Classification of Disease, 10th Revision Clinical Modification codes for specific HAIs: CDI, SSIs, catheter-associated urinary tract infections, catheter- and line-associated blood stream infections, and ventilator-associated pneumonias.
- Integration of HAI incidence data with hospital inpatient cost estimates to determine national economic impact.
Main Results:
- In 2016, HAIs incurred an estimated cost of $7.2 to $14.9 billion in the United States.
- Clostridioides difficile infection (CDI) was the most frequent HAI (56%), followed by surgical site infections (SSIs) (31%).
- Collectively, CDI and SSIs accounted for 79% of the total estimated cost of HAIs.
Conclusions:
- Health care-associated infections continue to impose a substantial economic burden on U.S. healthcare systems.
- Updated cost estimations highlight the significant financial impact of HAIs.
- Targeted interventions for prevalent and costly HAIs like CDI and SSIs are essential for mitigating economic losses.
Background:
Health care-associated infections (HAIs) are costly, and existing national cost estimates are out-of-date.
Methods:
We retrospectively analyzed the Agency for Healthcare Cost and Utilization Project's 2016 National Inpatient Sample, the largest all-payer U.S. inpatient database. We included all inpatient encounters with primary or secondary International Classification of Disease, 10th Revision Clinical Modification diagnosis codes corresponding to infection with catheter-associated urinary tract infections (T85.511), catheter- and line-associated blood stream infections (T80.211), surgical site infections (SSIs; T81.49), ventilator-associated pneumonias (J95.851), and Infection with Clostridioides difficile (CDI; A04.7). We combined HAI incidence data from the National Inpatient Sample with additional hospital inpatient HAI cost estimates to create national cost estimates for HAI individually and collectively.
Results:
In 2016, 7.2 to 14.9 billion U.S. dollars were spent on HAIs in the United States. For admissions with any diagnosis of HAI, the frequencies of HAI in descending order were as follows: CDI (n = 356,754 [56%]), SSI (n = 196,215 [31%]), catheter- and line-associated blood stream infection (n = 42,811 [7%]), catheter-associated urinary tract infection (n = 23,546 [4%]), and ventilator-associated pneumonia (n = 16,767 [3%]). Collectively, CDI and SSI accounted for 79% of the cost of HAI in the United States.
Conclusions:
Health care-associated infections remain a significant economic burden for health care systems in the United States.
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