title: Statewide costs of health care-associated infections: estimates for acute care hospitals in North Carolina.
abstract: BACKGROUND
  State-specific, health care-associated infection (HAI) cost estimates have not been calculated to guide Department of Public Health efforts and investments.
  
  
  METHODS
  We completed a cost identification study by conducting a survey of 117 acute care hospitals in NC to collect surveillance data on patient-days, device-days, and surgical procedures during 1 year. We then calculated expected rates and direct hospital costs of surgical site infections (SSI), Clostridium difficile infection, and 3 selected device-related HAIs for hospitals and the entire state using reference data sets such as the National Healthcare Safety Network.
  
  
  RESULTS
  In total, 67 (53%) hospitals responded to the survey. The median bed size of respondent hospitals was 140 (interquartile range, 66-350). A "standard" NC hospital diagnosed approximately 100 HAI each year with estimated costs of $985,000 to $2.7 million. The most common HAI was SSI (73%). Costs related to SSI accounted for 87% to 91% of overall costs. In total, the overall direct annual cost of these 5 selected HAIs was estimated to be between $124.1 and $347.8 million in 2009 for the state of NC.
  
  
  CONCLUSIONS
  Using conservative estimates, HAI led to costs of more than $100 million in acute care hospitals in the state of NC in 2009. The majority of costs were due to SSI.
authors: Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA. dja@duke.edu
authors: Deverick J
authors: DJ
authors: Anderson
authors: Deborah G
authors: DG
authors: Pyatt
authors: David J
authors: DJ
authors: Weber
authors: William A
authors: WA
authors: Rutala
mesh_terms: D055499:Catheter-Related Infections / Q000191:economics / Q000453:epidemiology; D003015:Clostridium Infections / Q000191:economics / Q000453:epidemiology; D003428:Cross Infection / Q000191:economics* / Q000453:epidemiology*; D017048:Health Care Costs; D006761:Hospitals; D006801:Humans; D009657:North Carolina / Q000453:epidemiology; D053717:Pneumonia, Ventilator-Associated / Q000191:economics / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000191:economics / Q000453:epidemiology
keywords: Financial analysis; Statewide quality improvement; Surveillance