Infection Prevention: Role Evolves but Resources, Funding Remain Static

Economic Impact of Infection Control

Making the business case for infection prevention and control to hospital administrators and other stakeholders has been quickly moving up the list of infection IPs’ priorities these days.

A session on economics and infection control presented at the 2005 meeting of the Association for Professionals in Infection Control and Epidemiology (APIC) was summarized in an AJIC article by Stone et al. (2005). Stone et al. (2005) presented a review of the literature on infection costs and showed that there will be increased pressure to establish cost-effective services – supported by evidence-based interventions — in healthcare, which by 2013 is projected to reach 18.4 percent of the U.S. gross domestic product. However, the process to determine such cost estimates is fraught with challenges. Stone et. al. (2002) conducted a review of the literature on HAI costs published from 1990 through 2000 and found that HAI costs associated with bloodstream infections, for example, ranged from $3,500 to $40,000 per survivor, due to differences in the cost-accounting methods. Stone et al. (2005) laments the lack of standardized methods of economic evaluations and suggests that ICPs and epidemiologists could use instruction on how to conduct such evaluations. Stone et al. (2005) comments, “We know that ‘money talks,’ but what many of us are still coming to grips with is that we are not as conversant in money matters as we need to be.”

Edwin C. Hedblom, an author of the Stone et al. (2005) paper, emphasizes the importance of health economics and how they can be used to demonstrate the financial and clinical value of infection control programs, and acknowledges, “As is generally recognized, resources are limited, wants and needs exceed resources, and choices must be made.” Despite cost-cutting strategies such as aggressive contracting, reducing employee benefits, and shifting costs to others, which have created some short-term savings, Hedblom advises these savings “can rarely be sustained because inflation and the increasing use of expensive technologies eventually offset the gain. Healthcare managers are consequently looking for new ways to cut costs and get more value for their money.”

Hedblom explains that some healthcare managers and clinicians are reluctant to use health economic analyses in their decision-making because of impediments such as institutional budget constraints, as well as insufficient training on how to interpret health economic data and how to translate evidence into practice. Hedblom, in Stone et al. (2005), comments, “Management clearly wants to improve patient and employee safety just as you do. In making the case for more money, however, you have to try to think like a chief financial officer. Economic research gives you the tools for more successful negotiations.”