Hospital Acquired Infections: The Diagnosis That Could Have You Paying an Extra $40,000 Per Patient

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Hospital-Acquired Infections: The Diagnosis

Hospital-acquired infections (HAIs) occur when a patient is exposed to a bacterium, virus, or fungus during their hospital stay that leads to an additional condition. An HAI diagnosis can cost hospitals thousands of dollars in lost revenue.

Common HAIs, like pneumonia or urinary tract infections, are preventable with proper hand hygiene, isolation procedures, and prophylactic antibiotics. Even so, these infections cost the U.S. healthcare system more than $4.5 billion annually.

When a patient enters the hospital for a procedure, part of their post-operative care plan is prophylactic antibiotics to help prevent infections — either from the surgical procedure itself or from something they may acquire through exposure to healthcare workers or other patients. While vigilant hand hygiene on the part of clinical staff certainly lessens the likelihood of passing infections from patient to patient, hospitals also need to adhere to broader infection prevention protocols.

Hospital-Acquired Infections: Prevention

Even the most robust infection prevention programs are challenged by an increase in antibiotic-resistant bacteria, the most notorious being staphylococcus. Even though “staph” exists on our skin naturally, when it is introduced to deeper tissues and the bloodstream it can cause a lethal infection. When antibiotics first became commonplace in modern medicine, they were used too liberally to treat these infections, and over the years the bacteria have evolved to resist them. Now, stronger antibiotics are needed as the first line of defense.

Methicillin-resistant Staphylococcus aureus (MRSA) has become endemic to hospitals in the United States and has created an additional 2.7 million extra hospital days for patients. The costs accrued from these extra stays are almost always the responsibility of the hospitals and patients. These infections usually cannot be reclassified into a higher diagnosis-related group (DRG), meaning the costs don’t get absorbed by third-party payers.

The solution for reducing infection rates may be simpler than hospitals think. Items commonly used in hospitals, such as blood pressure cuffs and stethoscopes, are so prevalent that they may not be a main focus of disinfecting habits. While hand washing is well regulated, and doctors and nurses are trained to wear gloves or other personal protective equipment when dealing with body fluids, these diagnostic tools may be regularly overlooked. Beyond disinfecting, some groups have proposed creating low-cost disposable blood pressure cuffs to eliminate reuse between patients.

Other infection prevention strategies that operate more globally within a healthcare system have shown measurable reductions in HAIs. The U.S. Department of Health and Human Services has issued a call to action for U.S. hospitals to eradicate HAIs. In 2008, a federal steering committee for the prevention of HAIs was established, and it has steadily initiated discussions about prevention — including a national action plan that concluded in 2013.

Ultimately, though, hospitals are going to be responsible for reining in costs related to HAIs — and for some, this will be no small task.

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If your healthcare organization is wondering where to begin in assessing your financial and administrative readiness for creating, or improving, an infection prevention program, BHM Healthcare Solutions can help. Call or email us today to set up a complimentary consultation.

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