PHC4 Research Brief | Issue 8, November 2005 - Reducing Hospital-Acquired Infections: The Business Case

PHC4 Research Brief - Reducing Hospital-acquired Infections: The Business Case - News Release

FOR IMMEDIATE RELEASE

Contact: Joe Martin, Communications Director
717-232-6787 or

TAXPAYERS FOOT THE BILL FOR MAJORITY OF HOSPITAL-ACQUIRED INFECTIONS IN PA

Harrisburg, PA - November 17, 2005 - The federal Medicare program and Pennsylvania’s Medicaid program were billed for 76 percent of the 11,668 hospital-acquired infections reported by Pennsylvania hospitals in 2004, according to a new Research Brief released today by the Pennsylvania Health Care Cost Containment Council (PHC4). Medicare and Medicaid were billed for 7,870 and 1,028 hospital-acquired infections, respectively. As a result, taxpayers footed the bill for $1 billion in additional hospital charges for Medicare patients and $372 million in additional hospital charges for Medicaid patients.

"The financial toll of potentially preventable hospital-acquired infections is staggering," said Marc P. Volavka, Executive Director of PHC4. "Our health care system is hemorrhaging money."

The average charges for Medicare patients with a hospital-acquired infection were about $160,000, compared to $32,000 for Medicare patients who did not contract an infection. For Medicaid patients, the average charges were approximately $391,000 for patients who contracted an infection while hospitalized, compared to an average of $29,700 where an infection did not occur. Private-sector commercial insurers, where the health care bills are paid primarily by businesses and labor unions that provide health insurance, were billed for almost 23 percent – or 2,633 – of the reported hospital-acquired infections, which added $604 million in extra hospital charges. The average charge for a hospital admission in which a commercially insured patient contracted a hospital-acquired infection was almost $258,000, compared to $28,000 for admissions where an infection did not occur. The average charges for a stay in which uninsured patients contracted an infection reached almost $230,000, compared to $21,000 for uninsured patients without an infection.

"Assuming that Pennsylvania hospitals are no better or worse than those anywhere else in the country, we can estimate that at least $20 billion was charged to Medicare to pay for hospital-acquired infections in this country during 2004," said Mr. Volavka. "Given that hospitals underreported the 2004 data, this number is undoubtedly low."

The average length of stay for Medicare patients who contracted a hospital-acquired infection (HAI) was 20.0 days, compared to 5.4 days for Medicare patients who did not have an HAI.
The average length of stay for Medicaid patients who contracted an HAI was 33.5 days, compared to 4.1 days for Medicaid patients who did not have an HAI.
The average length of stay for commercially insured patients who contracted an HAI was 24.3 days, compared to 3.7 days for commercially insured patients who did not have an HAI.
The average length of stay for an uninsured patient with an HAI was 21.1 days, compared to 3 days where no infection occurred.
Of the Medicare patients with an HAI, 16.1 percent died, compared to 3.7 percent of the Medicare patients without an HAI.
Of the Medicaid patients with an HAI, 16.0 percent died, compared to 1.1 percent of the Medicaid patients without an HAI.
Of the commercially insured patients with an HAI, 12.8 percent died, compared to 1.1 percent of the commercially insured patients without an HAI.
The mortality rate for uninsured patients with an HAI was 19.1 percent, compared to 2.2 percent for patients without an HAI.

PHC4 is an independent state agency charged with collecting, analyzing and reporting cost and quality health care information. Copies of the new report are free and available on the Council's website at http://www.phc4.org or by calling PHC4 at 717-232-6787.