Cost of Health Care–Associated Infections in the United States

BACKGROUND: Health care-associated infections (HAIs) are costly, and existing national cost estimates are out-of-date.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.