Financial Impact of CLABSI Prevention on Indian Hospitals: The Hospital Management Perspective

Introduction: Central line-associated bloodstream infections (CLABSI) impose a significant financial burden on patients and hospitals. This study evaluates the impact of CLABSI on hospital revenue loss and explores recovery potential through bed backfilling in an Indian tertiary care setting. Materials and Methods: A mathematical simulation model using a static decision tree was developed using published data to assess the economic impact of CLABSI over a 1-year time horizon from a hospital perspective, assuming 80% occupancy. This study was conducted between January and October 2025 and estimated the revenue loss per CLABSI case and modelled scenarios for 25% and 50% CLABSI rate reductions and varying backfill ratios. One-way sensitivity analysis (OWSA) varied inputs by ±10% to test robustness. Input parameters included CLABSI incidence, central line utilisation ratio, length of stay (LOS) and revenue for matched CLABSI versus non-CLABSI cohorts. Results: Each CLABSI case resulted in an estimated revenue loss of ₹2,86,132 (0.38% of potential revenue), driven by lower average revenue per bed-day (ARPOB) for CLABSI patients (₹27,990) versus non-CLABSI patients (₹50,000). Reducing CLABSI rates by 25% and 50% decreased revenue loss to 0.28% and 0.19% of potential revenue, respectively. Backfilling at a 3.33:1 ratio offset all lost revenue, while a 1.67:1 ratio recovered half of the lost revenue. Conclusions: Preventing CLABSI can significantly reduce hospital revenue loss, improve financial sustainability and lower patient treatment costs by minimising prolonged stays and out-of-pocket expenses. This health system projection model underscores the importance of allocating accurate and continued funding for healthcare-associated infections (HAIs) reduction programmes.