Bloodstream: Hospitals Profit from Infections

Photo: Central line

Hospitals in the US actually profit when patients suffer from central line-associated bloodstream infections (CLABSI); © Seemann

Johns Hopkins researchers report that hospitals may be reaping enormous income for patients whose hospital stays are complicated by preventable bloodstream infections contracted in their intensive care units.

In a small, new study, researchers found that an ICU patient who develops an avoidable central line-associated bloodstream infection (CLABSI) costs nearly three times more to care for than a similar infection-free patient. Moreover, hospitals earn nearly nine times more for treating infected patients, who spend an average of 24 days in the hospital.The researchers also found that private insurers, rather than Medicare and Medicaid, pay the most for patient stays complicated by CLABSIs — roughly 400,000 dollars per hospital stay — suggesting that private insurers would gain the most financial benefit from working with hospitals to reduce infection rates."We have known that hospitals often profit from complications, even ones of their own making," says medical doctor Peter J. Pronovost, senior vice president for patient safety for Johns Hopkins Medicine. "What we did not know was by how much, and that private insurers are largely footing the bill."

"This study suggests that it is in the financial interest of private insurers to help hospitals find a way to improve patient safety and reduce the number of these preventable infections," says Johns Hopkins anesthesiology resident medical doctor Eugene Hsu. "If the money spent on treating just one infection was spent on effectively implementing measures to prevent CLABSIs, insurers could save millions of dollars, and, more importantly, the needless suffering of patients would be reduced."

CLABSI infections occur when thin plastic tubes, or central lines, are placed in ICU patients to administer medication or fluids, obtain blood for tests, and directly gauge cardiovascular measurements such as central venous blood pressure. But the tubes are easily contaminated and each year roughly 80,000 patients with central lines become infected. Some 28,000 are estimated to die — nearly as many as those who die from breast cancer annually — and the cost of treating them may be as high as 3 billion dollar nationally, according to experts.

While the number of infections has been falling nationwide as a result of checklists and other safety measures developed and tested by Pronovost, he says less money is currently available from the government to put interventions in place, and that a good source to turn to would be private insurers who have the most to gain financially from them. Years ago, Johns Hopkins researchers, led by Pronovost, developed a much-heralded checklist and other interventions tested at The Johns Hopkins Hospital in Baltimore, and then adopted by hospitals in entire states such as Michigan and Rhode Island, that virtually eliminated catheter infections.; Source: John Hopkins Medicine