The Fiscal Case for Fighting Hospital Acquired Infections - Part 2

Read part one of this blog post here.

The Priciest Pathogens

Unsurprisingly, costs spike when an infection is caused by a superbug — by $6,000 to $30,000 per patient, according to a Chinese study. Compared to first-line medications, the last-resort drugs required to treat these infections are more expensive and more toxic, triggering side effects that require additional treatment.

Clostridium difficile, in particular, “represents a significant economic burden,” according to a review of 42 American studies.

The average case-management cost for C. difficile was $42,316 per patient, the review found, and C. difficile infections cost U.S. hospitals $6.3 billion annually, requiring nearly 2.4 million extra days of inpatient stay.

More worrisome: an “alarming increase C. difficile infections has been reported worldwide, along with higher recurrence rates, and more virulent strains of the bacteria have emerged.

MRSA infections hit hospital budgets hard, too, costing U.S. hospitals $3.2 billion to $4.2 billion annually, largely due to extended hospital stays.

In general, bacterial outbreaks cost hospitals considerably more than viral outbreaks.

“This is mainly due to easier and quicker detection, which reduces the duration and the microbiological costs,” scientists in the Netherlands concluded.

Still, hospitals can ill afford outbreaks of norovirus, measles, influenza, and other viruses.

Norovirus, because it’s so common, places a “substantial burden on healthcare systems,” costing the National Health Service (NHS) about £298 million per year. The main costs: beds kept unoccupied for infection control, staff absences due to infection, and cleaning and disinfection.

During one three-year period, norovirus outbreaks kept 57,800 beds empty.

“Overall, the total number of bed-days tied up by norovirus-associated gastroenteritis annually is equivalent to the entire daily NHS hospital bed capacity in England being unavailable for more than 2 days,” British researchers reported.

Investing in Prevention of Healthcare-Associated Infections

Mindful of budget constraints, hospitals tend to invest minimally in infection prevention. But this approach is “penny wise, pound foolish, ” suggest researchers who analyzed infection costs in 28 American hospitals.

Reducing infections by 25%, they estimated, could save these hospitals $6.5 million a year.

Clearly, prevention costs less than containment. But where should hospitals direct their prevention funds?

Improving hand hygiene is important, as hospital workers’ hands are the primary means of pathogen transmission. Hospitals must make hand rub readily available, keep dispensers and sinks in working order, and better train, monitor, and motivate staff.

Hospitals must also offer invest more in the cleaning and disinfection of surfaces, as pathogens are easily transmitted via bed rails, doorknobs, privacy curtains, IV poles, stretchers, supply carts, blood pressure cuffs, and so on.

However, meaningful improvements in hand hygiene and surface cleaning are difficult to achieve. Personnel are stretched too thin, and human error is inevitable.

“We are trying to solve problems of today with instruments of the past,” notes Ojan Assadian, M.D., president of the Austrian Society for Infection Control. “It is time to rethink our approach and combine existing strategies with new technology.”

The most effective new technology available to hospitals pertains to air disinfection.

Airborne transmission of MRSA, C. difficile, norovirus, tuberculosis, and numerous other pathogens is commonplace. A single vomiting episode can release 13,000 particles of norovirus into the air — yet patients can be infected with as few as 20 viral particles.

Sneezing, coughing, talking, and even breathing can launch infectious microbes airborne, where they can hover for hours before being inhaled by patients or landing on surfaces.

So it’s critical for hospitals to inactivate pathogens before they settle on surfaces and otherwise wreak havoc. Ultra-low energy plasma technology, deployed by Novaerus devices, accomplishes this in a cost-efficient manner.

Whereas HEPA filters only trap dangerous microbes, Novaerus technology kills pathogens on contact 24 hours a day, reducing infection rates in healthcare facilities.

Clostridium difficile and other infection rates are dropping at our hospital,” reports László Urbán, M.D., Ph.D., director-general of Hungary’s Mátrai Gyógyintézet hospital, which has installed 68 Novaerus units.

Given the high costs associated with surgical-site infections, hospitals commonly install Novaerus technology in operating theatres. Other areas typically outfitted with the units include isolation rooms, the ICU, emergency rooms, and neonatal wards.

While hospitals may assume they can’t afford to invest more in infection prevention, research has proven the opposite: Hospitals can’t afford not to.