Page 19 - Insurance Times January 2018 Sample

patients with CDI who had a readmission within 30 days The causes of HCAI have been fairly well identified. Amongst
compared with all other patients (30.1% vs 14.4%). [19] the important ones are- improper hand hygiene, prolonged
and injudicious use of catheters, improper handling of
Cost of Treatment: urinary collection systems and airborne transmission of
infectious agents caused by less than adequate respiratory
A study by the Center for Disease Dynamics Economics &
Policy has shown the additional cost of treatment due to precautions. [6]
HCAI in US amounts to 9.8 billion US dollars annually.
Healthcare associated infections (HCAI) and antimicrobial
resistance are two main threats to the morbidity & mortality
The healthcare payer system has to meet the additional
to patients being treated in intensive care units. HCAI
expenses due to, the additional length of stay, the cost of
become major determinants of patient treatment outcome.
additional higher drugs that need to be administered due
to drug resistance of the infecting organisms and the The associated increased morbidity, mortality, and excess
prolonged morbidity and higher mortality with its LOS have a direct impact on the financial costs of treatment.
accompanying loss of earning for the family.
Healthcare acquired infections rate has been rising in
developing countries. This has led to significant increase in
The 11.4 % additional cost was related only to the additional
LOS. There is also additional cost of treatment due to the LOS and medication costs. Emergence of drug resistant
higher antibiotics administered due to drug resistance to species of common infective agents such as MRSA, VRE, and
routine drugs. others add to the burden of medical treatment costs.

Patients with HCAI spend higher number of bed days and
Discussion: cost higher than average patients without HCAI. Patients
Healthcare associated infections (HCAI) and antimicrobial with HAI have a larger proportion of readmissions compared
resistance are principal threats to the patients of intensive with patients with no HAI (29.0% vs 16.5%).
care units, surgical and burns wards. These remain the major
determining factors for determination of patient treatment Of the total bed days, 9.3% was considered to be excess days
outcome. They are associated with increased morbidity, attributed to the group of patients with an HAI. The excess
mortality, excess & prolonged hospitalization and higher LOS comprised 11.4% of the total costs [10]
financial costs of medical treatments. The incidence of HCAI
varies between 3.9% and 34% of all hospital admissions.[7]. Increasing healthcare costs affect the economical
Patients affected by HCAI have a longer hospital stay functioning of healthcare providers and payers. Apart from
sometimes in excess of 23 days which is about 4 to 5 times the direct financial burden on patients it also leads to
the average LOS of 5 days for their counterparts who have indirect costs in form of loss of income for the patients and
not been infected by HCAI. their families.

Also, patients with HCAI discharged from the hospital have It is imperative for healthcare organizations and payers to
a higher readmission rate of 29% (as against readmission make hospitals accountable for the occurrence of HCAI and
rate of 16.5 % for non HCAI patients)for any of the its related increase in direct and indirect cost of treatment.
complications of HCAI thereby adding to the cost of a
second hospitalization under bed days and medication HCAI also lead to significant morbidity & mortality adding
charges for higher medicines in infections by drug resistant to the sufferings of the patients and their families.It may
organisms. be argued that an increase in mortality would reduce the
LOS and cost of treatment but it may be equally true that
Patients with HCAI have a higher 30 day mortality of 17.4% the prolonged morbidity period and cost may then convert
as compared to patients without HCAI. This may falsely a morbidity into mortality.
reduce the cost and LOS findings due to early death
following HCAI. Follow up patients with HCAI have a lower Sheng et alfoundan additional LOS was around 20 days for
mortality of 15.8%. patients affected by an HCAI.
Health care associated infections are largely preventable, They also addressed a difficulty regarding estimating costs
but are associated with considerable health care burden. for HAIs among inpatients by pointing out a higher mortality

The Insurance Times, January 2018 19

Sashi Publications Pvt Ltd Call 8443808873/ 8232083010