Brief reportCost of bloodstream infections
Section snippets
Data and methods
Study data were gathered from the records of 1,355,647 admissions during a period from March 2001 through January 2006 in 55 participating hospitals using the Cardinal Health/MedMined (Birmingham, AL) services installed database. Nosocomial infections (NIs) and BSIs were identified by the Nosocomial Infection Marker (NIM; copyright, patent pending, Cardinal Health, Inc), a well-validated, electronic, laboratory-based marker used for automatic infection surveillance.6 The NIM is defined as a
Results
Data from 1,355,647 admissions included information on 58,376 presumed NIs; of these, 12,578 (21.6%) were identified as BSIs. Basic regression analysis yielded an estimated BSI-associated incremental cost of $19,643 (P < .0001; 95% confidence interval [CI]: $9026-$30,260). The distribution of BSIs as a function of LOS showed that more than half of all BSIs occurred within the first week of hospitalization and that 80% occurred within the first 2 weeks (Fig 1).
Discussion
This analysis of infections that occurred before hospital day 14 showed that BSIs were associated with increased costs of care of $19,643, which is consistent with previous estimates. The significance of these findings relate to the large sample size, which provided greater precision compared with previous studies and the use of actual cost-accounting data rather than charges or reimbursements.
How cost estimates may be biased by unobserved factors was also explored. When infections that
Conclusion
Even when intentionally underestimated, BSI-associated increased costs are substantial. The true incremental cost of care associated with BSIs is likely to lie between $10,000 and $20,000. Further research is needed to explore how controlling BSI costs may affect costs of inpatient care.
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Disclosures: Dr. Kilgore received an honorarium for participating in the symposium and writing this article.