The Investment Case for Preventing NICU-Associated Infections

Edward F. Donovan; Karen Sparling; Michael R. Lake; Vivek Narendran; Kurt Schibler; Beth Haberman; Barbara Rose; Jareen Meinzen-Derr; on behalf of the Ohio Perinatal Quality Collaborative

doi:10.1055/s-0032-1322516

American Journal of Perinatology, Table of Contents

Am J Perinatol 2013; 30(03): 179-184
DOI: 10.1055/s-0032-1322516

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Investment Case for Preventing NICU-Associated Infections

Edward F. Donovan

¹Ohio Perinatal Quality Collaborative Executive Committee and James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

,

Karen Sparling

²Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

,

Michael R. Lake

³Budget and Financial Integrity, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

,

Vivek Narendran

²Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

⁴University Hospital, Cincinnati, Ohio

,

Kurt Schibler

²Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

⁵Good Samaritan Hospital, Cincinnati, Ohio

,

Beth Haberman

²Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

⁶Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

,

Barbara Rose

¹Ohio Perinatal Quality Collaborative Executive Committee and James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

,

Jareen Meinzen-Derr

²Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

⁷Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

,

on behalf of the Ohio Perinatal Quality Collaborative

› Author Affiliations

Abstract

Background Nosocomial [hospital-associated or neonatal intensive care unit (NICU)-associated] infections occur in as many as 10 to 36% of very low-birth-weight infants cared for in NICUs.

Objective To determine the potentially avoidable, incremental costs of care associated with NICU-associated bloodstream infections.

Study Design This retrospective study included all NICU admissions of infants weighing 401 to 1500 g at birth in the greater Cincinnati region from January 1, 2005, through December 31, 2007. Nonphysician costs of care were compared between infants who developed at least one bacterial bloodstream infection prior to NICU discharge or death and infants who did not. Costs were adjusted for clinical and demographic characteristics that are present in the first 3 days of life and are known associates of infection.

Results Among 900 study infants with no congenital anomaly and no major surgery, 82 (9.1%) developed at least one bacterial bloodstream infection. On average, the cost of NICU care was $16,800 greater per infant who experienced NICU-associated bloodstream infection.

Conclusion Potentially avoidable costs of care associated with bloodstream infection can be used to justify investments in the reliable implementation of evidence-based interventions designed to prevent these infections.

Keywords

quality improvement - investment case - nosocomial infection

Full Text

References

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