Hospital Acquired Infections and Its Impact on Hospital Finances - Essay Example

The study involved analyzing the hospital management database and the management system database for the infection control in hospital of patients who were hospitalized in the Intensive Care Unit at Santa Casa de Belo Horizonte including a surgical unit, a cardiovascular unit, and two clinical unit. The costs were reported in Real (the Brazilian national currency). The researcher performed an analyses of length and cost for all costs that were studied. Using the median, the costs involved were determined. Costs were then adjusted by the length of stay of a patient in the Intensive care unit (ICU).  

The potential budget impact of hospital acquired infections

The median costs per day, median costs per hospitalization, and median costs per length of stay within the ICU for all patients were R$381,00 (185.22-753.20), R$1.257,00 (462.97-3924.47), and 3 (2-7) days respectively. The median costs per day, was R$803,59 [456.29-943.02) for surgical site infections, R$495,00 (353.68-605.47) for the patients presented with urinary tract infections,  R$602,17 (409.52- 953.94) for ventilator-associated pneumonia, and R$666,47 (420.30-821.53) for catheter associated bloodstream infections. In this study, surgical site infections were linked with higher cost per day, which was R$803, 59 (456.29-943.02).

In this study, the infected patients had somewhat longer stays compared to infected patients [15 (11-25)] against 3 (2-6) days respectively, p< .01. Increased costs per patient was R$9.763,78 (5445.64-18,007.90), against R$1.093,94 (416.14-2755.90), respectively, p<.01, and the ICU hospitalization increased costs per day was R$618,00 (407.81-838.69) against R$359,00 (174.59-719.12), respectively, p<.01). The bloodstream infections and ventilator-associated pneumonia were associated with a higher cost per day. This comparison was obtained from a multivariate analysis. These study findings show that the rate of Hospital-acquired infections (HI) in the Intensive Care Unit conforms to the previously reported studies. Ventilator-associated Pneumonia was reported as the most frequent infection. As noted, the patient with infections particularly catheter-associated bloodstream infections and surgical site infections had higher Intensive Care Unit costs. Additionally, the costs of antimicrobials, most of the other life support resources used for Intensive Care Unit patients may be responsible for the increase in costs. In

In another study, SHorn, Porpit & Ubonrate (1989) sought to investigate the “Extra Charge, Extra Length of Hospitalization and Mortality Associated with Nosocomial Infection”. In this study, Shorn. Port & Ubonrate N. 1989) utilized a matched-pair analysis to measure how the acquisition of nosocomial infections impacts the hospital charges and length of hospital stay of those patients who were admitted to Songklanagarind Hospital. In doing so, 530 patients were identified on Dec 31, 1987through routine surveillance as having a nosocomial infection. The identified patients were matched with those patients who had been admitted to the hospital in the same period through selecting from available data banks. Control subjects were individually matched to the infected patients by operative procedure, primary diagnosis, age group, and sex. In cases where one control was found, secondary operation or secondary diagnosis was used for selecting the closest control. Primary procedures and primary diagnosis were matched by the International Classification’s four-digit codes. Based on these matching schemes, seventy matched pairs of case-control were identified from the total 530 patients who were infected and an additional 14,000 patients were discharged from the hospital. The hospital summary billing statements provided the hospital charge for patients under study. Information of length of hospital stay, mortality outcome, and site infections was obtained from nosocomial or computer infection infections surveillance data.

The potential budget impact of hospital-acquired infections

The mean of hospital charge and hospital stay of patients with Hospital-acquired infections were recorded as 38 days and 16,230 bahts respectively. The mean hospital charge and mean length of stay in the hospital were 7,683 bahts and 16.4 days.  The mean difference of hospital charge and mean difference for hospital stay were 8,537 bahts (p=.0003), and 21.5 days (p<.0001) respectively. When this was stratified with a multiplicity of infections, the study found 43 cases of single infections with a mean of 19.67 extra days and an extra charge of 7,254.  Twenty-seven patients who had multiple infections had 10,676 bahts extra charge and 24.58 extra days. Patients with nosocomial or Hospital-acquired infections had a mortality rate of 24.3 percent.