Reed Deoine, Kemmerly Sandra A
Ochsner J. 2009 Spring;9(1):27-31.
The Centers for Disease Control and Prevention estimates that 2 million patients suffer from hospital-acquired infections every year and nearly 100,000 of them die. Most of these medical errors are preventable. Hospital-acquired infections result in up to $4.5 billion in additional healthcare expenses annually. The U.S. government has responded to this financial loss by focusing on healthcare quality report cards and by taking strong action to curb healthcare spending. The Medicare Program has proposed changes to the Hospital Inpatient Prospective Payment System and Fiscal Year Rates: Proposed Rule CMS 1488-P-Healthcare-associated infection. Payment will be linked to performance. Under the new rule, payment will be withheld from hospitals for care associated with treating certain catheter-associated urinary tract infections, vascular catheter-associated infections, and mediastinitis after coronary artery bypass graft surgery. Infection-prevention strategies are essential. In the healthcare setting, the infection control department is categorized as non-revenue-producing. Funds dedicated to resources such as staff, educational programs, and prevention measures are vastly limited. Hospital leaders will need to balance the upfront cost needed to prevent hospital-related infections with the non-reimbursed expense accrued secondary to potentially preventable infections. The purpose of this paper is to present case studies and cost analysis of hospital-acquired infections and present strategies that reduce infections and cost.
美国疾病控制与预防中心估计，每年有200万患者遭受医院获得性感染，其中近10万人死亡。这些医疗差错大多是可以预防的。医院获得性感染每年导致额外的医疗费用高达45亿美元。美国政府通过关注医疗质量报告卡并采取强有力措施控制医疗支出，来应对这一经济损失。医疗保险计划已对医院住院患者预期支付系统和财年费率提出了变更：拟议规则CMS 1488 - P - 医疗相关感染。支付将与绩效挂钩。根据新规则，对于与治疗某些导管相关的尿路感染、血管导管相关感染以及冠状动脉搭桥手术后的纵隔炎相关的护理，将扣减医院的支付款项。感染预防策略至关重要。在医疗环境中，感染控制部门被归类为不产生收入的部门。用于人员、教育项目和预防措施等资源的资金极为有限。医院领导需要在预防医院相关感染所需的前期成本与因潜在可预防感染而产生的未报销费用之间取得平衡。本文的目的是展示医院获得性感染的案例研究和成本分析，并提出减少感染和成本的策略。
