Transcript Costs

Costs
1. Describe the financial impact that
healthcare-associated infections have
on individuals and organisations.
2. Outline the types of costs associated
with HAIs.
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Learning objectives
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• 30 minutes
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Time involved
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• Healthcare-associated infections (HAI)
delay discharge, increase costs
• HAIs add to numbers of laboratory and
diagnostic investigations
• HAIs increase infection prevention and
control costs, including investigations and
medical, nursing and management time
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Key Points
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Hospitalisation Costs
Use of antibiotics
Increased length of hospitalisation
Intervention Costs
Potential intensive care unit stay
Tests performed
Barriers used (e.g., gown, gloves)
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Economic Consequences
Nurse/physician time
Outpatient/Community Care Costs
Potential need for an isolation room
Physician visits
Use of antibiotics
Home health visits
Patient Costs/Outcomes
Rehabilitation center stay
Mortality
Morbidity
Lost wages
Travel expenses
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• Studies generally focus on
• Severity of healthcare-associated infections
• Risk for patient safety
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Cost Estimates
• Study in England, 1994-5
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4,000 patients
7.8% of patients had an HAI
2.5 times longer length of stay
2.8 times greater hospital costs
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• Cost minimisation
• Cost effectiveness
• Cost benefit
• Cost utility
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Types of Economic
Evaluations - 1
The most preferred analyses are costeffectiveness and cost utility
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• Cost-effectiveness analysis
• compares interventions or products with different
costs and different effectiveness
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Types of Economic
Evaluations - 2
• Cost utility analysis
• the benefits of a specific intervention adjusted by
health preference scores
• useful when are no expected mortality differences
between interventions, only differences in physical
well-being expressed as quality adjusted life years
(QALY)
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• Costs that can be measured
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Health care facility costs
Health care facility charges
Resources used
Actual reimbursed charges
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Types of Economic
Evaluations - 3
• Hospital costs are a useful measure
• Best reflection of the actual economic burden to the
institution
• If only charges available, adjust the data using
cost-to-charge ratios
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• 4-month outbreak of Klebsiella pneumoniae
infection
• More than $300,000 in 2001 USA dollars
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Costs of Outbreaks
• MRSA in Canadian hospitals
• $42m - $59m Canadian dollars annually
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USA
• Low estimate
• $10,443 per infection in 2005 dollars
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Costs of Surgical Site Infections
• High estimate
• $25,546 per infection in 2002 dollars
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USA
• Low estimate
• $11,897 per infection in 1999 dollars
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Costs of Ventilator-Associated
Pneumonia
• High estimate
• $25,072 per infection in 2005 dollars
Argentina
• Extra costs US $2,255
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USA
Range $5,734 - $22,939 per infection in 2003 dollars
Italy
Total cost averaged € 9,000 (completed during 20042006)
Belgium
Attributable cost €13,585 (presented 2003)
Europe
Excess cost € 4,200–13,030
Mexico
Excess cost US$ 11,591
Argentina
Average US$4,888
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Costs of Bloodstream Infections
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USA
• Low estimate
• $589 per infection in 1998 dollars
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Costs of Urinary Tract Infections
• High estimate
• $758 per infection in 2006 dollars
UK
• Extra cost estimated at £1,122 (~2006)
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• Study on the Efficacy of Nosocomial Infection
Control (SENIC) of 1974-1983
• USA hospitals with 1 full-time infection control
nurse (ICN) per 250 beds, an infection control
doctor (ICD), moderately intense surveillance,
and systems for reporting wound infection rates
to surgeons reduced healthcare-associated
infection rates by 32%
• In other hospitals the healthcare-associated
infection rate increased by 18%
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Cost-benefit of Infection
Prevention and Control
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Align programs with organisational goals by:
1. Identifying areas in which the infection prevention
and control program can support and enhances
revenues
2. Avoiding excess costs for care, especially those
related to HAIs
3. Identifying opportunities for cost reduction through
value analysis
4. Participating in efforts to measure and prevent other
adverse outcomes of care
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Infection Prevention and
Control
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• Gianino MM, et al. A model for calculating costs of hospital-acquired
infections: an Italian experience. J Health Organization Mngt. 2007;
21 (1): 39.
• World Health Organization. Threshold values for intervention costeffectiveness by Region.
www.who.int/choice/costs/CER_levels/en/index.html
• Perencevich E, et al. Raising Standards While Watching the Bottom
Line Making a Business Case for Infection Control Intervention.
Infect Control Hosp Epidemiol 2007; 28:1121-1133.
• Haley RW, et al. The efficacy of infection surveillance and control
programs in preventing nosocomial infections in US hospitals. Amer J
Epidemiol 1985; 121:182-205.
• Kilgore ML, et al. The Costs of Nosocomial Infections. Medical Care.
2008; 46 (1):101-104.
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References
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1. One of the most preferred cost analyses are costeffectiveness. T/F?
2. An analysis of cost of infections should include:
a)
b)
c)
d)
Antibiotics
Gown use
Type of room
All of the above
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Quiz
3. The infection control team should never be
concerned about costs of infections. T/F?
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• IFIC’s mission is to facilitate international networking in
order to improve the prevention and control of
healthcare associated infections worldwide. It is an
umbrella organisation of societies and associations of
healthcare professionals in infection control and related
fields across the globe .
• The goal of IFIC is to minimise the risk of infection within
healthcare settings through development of a network of
infection control organisations for communication,
consensus building, education and sharing expertise.
• For more information go to http://theific.org/
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International Federation of
Infection Control
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