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Prevention of Cross Transmission of Microorganisms Is Essential to Preventing Outbreaks of Hospital-Acquired Infections

Hospital-acquired infections (HAIs) are becoming increasingly common worldwide and occur during more than two million hospitalizations in the United States each year.

Due to an increase in invasive procedures and a growing resistance to antibiotics, HAIs have increased by 36% in the last 20 years and are consuming more health care dollars each year.

The burdens these infections place on our health care system can be divided into three categories: the cost of quality, the cost of human lives and the financial impact.

The human cost is over 99,000 deaths per year in the United States, which represents a 5% death rate for HAIs.

Quality costs include increased ICU stays by 8 days, and increased average hospital stay between 7.4 and 9.4 days.

Total dollar costs added to the health care system are between $4.5 and $5.7 billion annually, with the average cost per infection of $13,973 and an increased cost to patients (who survived) of approximately $40,000. Specifically, methicillin-resistant Staphylococcus aureus (MRSA) has become endemic, even epidemic in many U.S. hospitals, and added 2.7 million extra days in the hospital with an average cost of $35,367.

Where do the funds come from to pay for HAIs? Do they come from third-party payers, Medicare/Medicaid, hospitals, or patients? Haley et al analyzed 9,423 nosocomial infections and found that only 5-18% of nosocomial infections would have caused the admission to be reclassified to a higher diagnosis related group (DRG). Of those hospitalizations able to be reclassified to a higher DRG, the extra payment only funded 5% of the total cost to treat the infection. That leaves 95% of the financial burden of HAIs to hospitals and patients.

David Schwegman, MD., Assistant Professor of Medicine, Emory University

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