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Direct health care costs and length of hospital stay related to health care-acquired infections in adult patients based on point prevalence measurements

Mikael Rahmqvist, PhD, Annika Samuelsson, MD, PhD, Salumeh Bastami, PhD, Hans Rutberg, MD, PhD

Highlights

 

  • •All admitted patients from 10 independent Point Prevalence Surveys (PPS).
  • •Actual direct healthcare costs were calculated, not templates, nor estimates.
  • •The 30-days Follow-up showed more re-admissions in the group with HAI.
  • •Patients with HAI had a greater portion of bed days and costs than average.
  • •Patients with HAI had a higher one year mortality rate than other patients.

 

Background

The incidence of health care-acquired infection (HAI) and the consequence for patients with HAI tend to vary from study to study. By including all patients, all medical specialties, and performing a follow-up analysis, this study contributes to previous findings in this research field.

Methods

Data from the Swedish National Point Prevalence Surveys of HAI 2010-2012 was merged with cost per patient data from the county Health Care Register (N = 6,823). Extended length of stay (LOS) and costs related to an HAI were adjusted for sex, age, intensive care unit use, and surgery.

Results

Patients with HAI (n = 732) had a larger proportion of readmissions compared with patients with no HAI (29.0% vs 16.5%). Of the total bed days, 9.3% was considered to be excess days attributed to the group of patients with an HAI. The excess LOS comprised 11.4% of the total costs (95% CI, 10.2-12.7). The 1-year overall mortality rate for patients with HAI in comparison to all other patients was 1.75 (95% CI, 1.45-2.11), all 5 of these differences were statistically significant (P < .001).

Conclusions

Even if not all outcomes for patients with an HAI can be explained by the HAI itself, the increase in inpatient days, readmissions, associated costs, and higher mortality rates are quite notable.

Zach Prideaux