Patient Safety Tip of the Week
August 21, 2007
Costly Complications About To Become Costlier
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”.
http://www.patientsafetysolutions.com
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Safety Tip of the Week Archive
What’s New in the Patient Safety World Archive