title: Estimating hospital costs of catheter-associated urinary tract infection.
abstract: Healthcare-associated infections are common, costly, and potentially deadly. However, effective prevention strategies are underutilized, particularly for catheter-associated urinary tract infection (CAUTI), one of the most common healthcare-associated infections. Further, since 2008, the Centers for Medicare and Medicaid Services no longer reimburses hospitals for the additional costs of caring for patients who develop CAUTI during hospitalization. Given the resulting payment pressures on hospitals stemming from this decision, it is important to factor in cost implications when attempting to encourage decision makers to support infection prevention measures. To this end, we present a simple tool (with easy-to-use online implementation) that hospitals can use to estimate hospital costs due to CAUTI, both before and after an intervention, to reduce inappropriate urinary catheterization. Using previously published cost and risk estimates, we show that an intervention yielding clinically feasible reductions in catheter use can lead to an estimated 50% reduction in CAUTI-related costs. Our tool is meant to complement the Society of Hospital Medicine's Choosing Wisely campaign, which highlights avoiding placement or continued use of nonindicated urinary catheters as a key area for improving decision making and quality of care while decreasing costs.
authors.affiliation: VA Center for Clinical Management Research, Ann Arbor VA Health Services Research and Development Center of Excellence, Ann Arbor, Michigan; Patient Safety Enhancement Program, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan; Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Edward H
authors.initials: EH
authors.lastname: Kennedy
authors.forename: M Todd
authors.initials: MT
authors.lastname: Greene
authors.forename: Sanjay
authors.initials: S
authors.lastname: Saint
mesh_terms: D055499:Catheter-Related Infections / Q000191:economics* / Q000453:epidemiology; D003428:Cross Infection / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology; D017721:Hospital Costs; D006801:Humans; D011787:Quality of Health Care / Q000191:economics; D014546:Urinary Catheterization / Q000009:adverse effects / Q000191:economics*; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology
references.citation: Am J Infect Control. 2000 Feb;28(1):68-75
references.pmid: 10679141
references.citation: Infect Control Hosp Epidemiol. 2007 Oct;28(10):1121-33
references.pmid: 17933084
references.citation: Clin Infect Dis. 2010 Sep 1;51(5):550-60
references.pmid: 20673003
references.citation: Am J Infect Control. 2012 May;40(4):359-64
references.pmid: 21868133
references.citation: Acad Emerg Med. 2010 Mar;17(3):337-40
references.pmid: 20370769
references.citation: J Am Geriatr Soc. 1999 Dec;47(12):1453-7
references.pmid: 10591242
references.citation: Public Health Rep. 2007 Mar-Apr;122(2):160-6
references.pmid: 17357358
references.citation: Arch Intern Med. 2012 Feb 13;172(3):260-1
references.pmid: 22231612
references.citation: Ann Intern Med. 2009 Jun 16;150(12):877-84
references.pmid: 19528567
references.citation: Ann Intern Med. 2002 Jul 16;137(2):125-7
references.pmid: 12118969