We’ve talked previously about the costs associated with various complications, such as urinary tract infections, post-stroke pneumonia, etc. Average costs for such complications have been estimated as below:
Urinary Tract Infection $ 3,000
Pneumonia after Stroke $15,000
Adverse Drug Event $ 6,000
DVT dx and rx $13,000
Fall with Injury $34,000
Ventilator-assoc. Pneumonia $40,000
Decubitus $500 to $40,000
MRSA infection $27,000
C. diff infection $40,000
Surgical site infection $13,000
Some of those costs have been offset in the past by higher reimbursements to hospitals for cases “with complications”. Well, that is also about to end. CMS has announced that it plans in 2008 to stop Medicare reimbursement for cases in which certain preventable complications have occurred . Almost all the above complications make the CMS list. Thus, the financial incentive to provide high quality care and enhance patient safety will increase dramatically. And you can expect private third party payors to follow CMS in this change in reimbursement. While we expect that the list will be refined before actual implementation, the message is clear: Medicare will no longer pay for preventable complications.
It behooves all facilities to ensure they have appropriate patient safety/quality improvement programs in place to minimize the risk of these complications.
CFO’s have traditionally focused much more on the revenue side of the balance sheet than the cost avoidance side. Justifying patient safety initiatives to CFO’s should no longer be difficult when you put together a spreadsheet with the above averages times the number of occurrences at your facility.
Update from out November 2007 What’s New in the Patient Safety World:
Cost of adverse events in intensive care units
Add to the above the costs of adverse events in ICU’s. Kaushal et al published a study of the cost for adverse events in ICU’s. The average cost per adverse event for patients in the MICU was $3961 and the attributable increase in LOS was 0.77 days. Corresponding numbers for patients in the CCU were $3857 and 1.08 days. The extrapolated annual cost for adverse events in these two 10-bed ICU’s was nearly $1.5 million. Clearly, there is significant opportunity for costs savings in prevention of adverse events in this setting. Organizations looking for a good ROI (return on investment) in their patient safety programs may want to focus on ICU’s.
Kaushal R, Bates DW, Franz C, Soukup JR, Rothschild JM. Cost of adverse events in intensive care units. Critical Care Med 2007; 35: 2479–2483
Please also see our January 22, 2008 Patient Safety Tip of the Week “More on the Cost of Complications”and our April 22, 2008 Patient Safety Tip of the Week “CMS Expanding List of No-Pay Hospital-Acquired Conditions”.