Medicare reimbursement attributable to catheter-associated urinary tract infection in the inpatient setting: a retrospective cohort analysis.
BACKGROUND
Most catheter-associated urinary tract infections (CAUTIs) are considered preventable and thus a potential target for health care quality improvement and cost savings.


OBJECTIVE
We sought to estimate excess Medicare reimbursement, length of stay, and inpatient death associated with CAUTI among hospitalized beneficiaries.


METHODS
Using a retrospective cohort design with linked Medicare inpatient claims and National Healthcare Safety Network data from 2009, we compared Medicare reimbursement between Medicare beneficiaries with and without CAUTIs.


METHODS
Fee-for-service Medicare beneficiaries aged 65 years or older with continuous coverage of parts A (hospital insurance) and B (supplementary medical insurance).


RESULTS
We found that beneficiaries with CAUTI had higher median Medicare reimbursement [intensive care unit (ICU): $8548, non-ICU: $1479) and length of stay (ICU: 8.1 d, non-ICU: 3.6 d) compared with those without CAUTI controlling for potential confounding factors. Odds of inpatient death were higher among beneficiaries with versus without CAUTI only among those with an ICU stay (ICU: odds ratio 1.37).


CONCLUSIONS
Beneficiaries with CAUTI had increased Medicare reimbursement and length of stay compared with those without CAUTI after adjusting for potential confounders.
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
Sarah H
SH
Yi
James
J
Baggs
Carolyn V
CV
Gould
Robert D
RD
Scott
John A
JA
Jernigan
D000368:Aged; D000369:Aged, 80 and over; D055499:Catheter-Related Infections / Q000191:economics*; D015331:Cohort Studies; D003428:Cross Infection / Q000191:economics* / Q000401:mortality / Q000517:prevention & control; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D007362:Intensive Care Units / Q000191:economics; D007902:Length of Stay / Q000191:economics; D008297:Male; D015442:Medicare Assignment / Q000191:economics*; D016344:Medicare Part A / Q000191:economics*; D016345:Medicare Part B; D058996:Quality Improvement / Q000191:economics; D012189:Retrospective Studies; D014481:United States; D014552:Urinary Tract Infections / Q000191:economics* / Q000401:mortality / Q000517:prevention & control