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How CLABSIs Reduce Profits

In February 2007, the Association for Professionals in Infection Control and Epidemiology (APIC) published a briefing titled "Dispelling the Myths: The True Cost of Healthcare-Associated Infections." In it, the authors reported on a recent study of 1.69 million admissions at 77 hospitals; this revealed that patients with a healthcare-acquired infection reduced overall net inpatient profit margins by a total of $286 million (or $5,018 per infected patient). The study also found that "in classes where reimbursement is lower, the loss impact is even greater."1

To bolster their point about infections eroding profitability, the APIC briefing's authors cite the results of a 40-hospital campaign by the Jewish Health Foundation and Pittsburgh Regional Health Initiative to eliminate Central Line-Associated Bloodstream Infections (CLABSIs). The experience at Allegheny General Hospital was especially noteworthy. This institution reduced CLABSIs by 90 percent, and in doing so recorded the following data:

Average reimbursement per case $64,894
Average cost per case with a CLABSI $91,733
Average loss per case $(26,839)
Percent of total cost of care associated with a CLABSI 43%

The cost of CLABSIs has never been higher. In 2008, the Centers for Medicare and Medicaid Services (CMS) announced that it would no longer reimburse CLABSI treatment costs or "never events".2 Starting in 2011, hospitals participating in the Inpatient Prospective Payment System (IPPS) will be required to report their CLABSI rates to the CDC per the CMS's effort to drive down CLABSI rates. Starting in 2013, those hospitals not reporting their infection rate will be subject to a 2% reduction in their Medicare reimbursement.3


REFERENCES


1 Murphy, D., Whiting, J. Dispelling the Myths: The True Cost of Healthcare-Associated Infections. An APIC Briefing, February 2007.

2 Herb, Kuhn. United States. Never Events. Baltimore: 2008. Web. 24 Feb 2011. http://www.cms.gov/SMDL/downloads/SMD073108.pdf.

3 Pyrek, K. M. Public Reporting of Infections & the CLABSI Mandate. Infection Control Today. Jan. 2011; Vol. 15 (1): 8-16.