Study: Recounting the cost of CAUTIs

Nurse Leader Insider, April 12, 2018

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This is an excerpt from the May issue of Briefings on Accreditation and Quality.

You probably know that CMS doesn’t reimburse for hospital-acquired infections (HAI), including catheter-associated urinary tract infections (CAUTI), the most common healthcare-associated condition in the U.S.

What you may not know is that CAUTIs cost hospitals far more than most think. While most say the average cost of treating a CAUTI is $1,000, that figure is likely too low. In some cases, it’s 10 times too low.

That’s according to a new study published in the American Journal of Infection Control. The study was written by Christopher S. Hollenbeak, PhD, professor of surgery and public health sciences at Pennsylvania State University, and Amber L. Schilling, PharmD, MEd, research analyst at the Penn State College of Medicine.

The pair systematically reviewed patient-level cost data, focusing on studies conducted in the United States between 2000 and 2017.

“We can conclude that the prevailing notion of a CAUTI costing approximately $1,000 is an underestimate and an oversimplification of its true economic burden,” Hollenbeak and Schilling wrote. “Many factors can increase the attributable cost well above $1,000.”

This means it’s time to reexamine how you prioritize catheter infections.

Using data they gathered, they found that CAUTI costs ranged from $876 to $10,197 when inflation-adjusted into the equivalent of 2016 dollars. The low end of that range came from a study of adult patients in an inpatient setting, with costs calculated from the hospital’s perspective. The high end came from a study of ICU patients, with costs calculated from Medicare’s perspective. The numbers in between looked like this:

  • $876 for inpatient cost to the hospital for additional diagnostic tests and medications
  • $1,764 for inpatient cost to Medicare for non-ICU patients
  • $7,670 for inpatient and outpatient costs to Medicare
  • $8,398 for inpatient cost to the hospital for pediatric patients
  • $10,197 for inpatient cost to Medicare for ICU patients

The review suggests that a CAUTI’s cost depends heavily upon the patient’s acuity, the population being served (e.g., adult or pediatric), and the cost perspective (e.g., hospital or Medicare). However, the researchers said more research is needed.

Even with these rough numbers, there is reason to believe CAUTIs could be costing the U.S. much more than previously thought, they wrote. The Centers for Disease Control and Prevention’s National Healthcare Safety Network estimated in 2009 that CAUTIs in the U.S. carry a total economic burden of $340 million annually, but the AJIC study suggests the number is closer to five times that amount: $1.7 billion.

For more information on how to address CAUTIs in your facility, check out the Strategies for Nurse Managers Reading Room:

Case Study: Hospitalwide Huddles Curb Catheter Infections at Saint Anthony

New NPSG addresses CAUTIs

Make support staff part of infection control

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