Underresourced Hospital Infection Control and Prevention Programs: Penny Wise, Pound Foolish?

OBJECTIVES: To estimate the cost of healthcare-associated infections (HAIs) in a network of 28 community hospitals and to compare this sum to the amount budgeted for infection control programs at each institution and for the entire network. DESIGN: We reviewed literature published since 1985 to estimate costs for specific HAIs. Using these estimates, we determined the costs attributable to specific HAIs in a network of 28 hospitals during a 1-year period (January 1 through December 31, 2004). Cost-saving models based on reductions in HAIs were calculated. SETTING: Twenty-eight community hospitals in the southeastern region of the United States. RESULTS: The weight-adjusted mean cost estimates for HAIs were 25, 072 per episode of ventilator-associated pneumonia, 23, 242 per nosocomial blood stream infection, 10, 443 per surgical site infection, and 758 per catheter-associated urinary tract infection. The median annual cost of HAIs per hospital was 594, 683 (interquartile range IQR, 299, 057-1, 287, 499). The total annual cost of HAIs for the 28 hospitals was greater than 26 million. Hospitals budgeted a median of 129, 000 (IQR, 92, 500-200, 000) for infection control; the median annual cost of HAIs was 4. 6 (IQR, 3. 4-8. 0) times the amount budgeted for infection control. An annual reduction in HAIs of 25% could save each hospital a median of 148, 667 (IQR, 74, 763-296, 861) and could save the group of hospitals more than 6. 5 million. CONCLUSIONS: The economic cost of HAIs in our group of 28 study hospitals was enormous. In the modern age of infection control and patient safety, the cost-control ratio will become the key component of successful infection control programs.