Medicare reimbursement attributable to catheter-associated urinary tract infection in the inpatient setting: a retrospective cohort analysis

Med Care. 2014 Jun;52(6):469-78. doi: 10.1097/MLR.0000000000000106.

Abstract

Background: Most catheter-associated urinary tract infections (CAUTIs) are considered preventable and thus a potential target for health care quality improvement and cost savings.

Objectives: We sought to estimate excess Medicare reimbursement, length of stay, and inpatient death associated with CAUTI among hospitalized beneficiaries.

Research design: Using a retrospective cohort design with linked Medicare inpatient claims and National Healthcare Safety Network data from 2009, we compared Medicare reimbursement between Medicare beneficiaries with and without CAUTIs.

Subjects: Fee-for-service Medicare beneficiaries aged 65 years or older with continuous coverage of parts A (hospital insurance) and B (supplementary medical insurance).

Results: We found that beneficiaries with CAUTI had higher median Medicare reimbursement [intensive care unit (ICU): $8548, non-ICU: $1479) and length of stay (ICU: 8.1 d, non-ICU: 3.6 d) compared with those without CAUTI controlling for potential confounding factors. Odds of inpatient death were higher among beneficiaries with versus without CAUTI only among those with an ICU stay (ICU: odds ratio 1.37).

Conclusions: Beneficiaries with CAUTI had increased Medicare reimbursement and length of stay compared with those without CAUTI after adjusting for potential confounders.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Catheter-Related Infections / economics*
  • Cohort Studies
  • Cross Infection / economics*
  • Cross Infection / mortality
  • Cross Infection / prevention & control
  • Female
  • Hospital Mortality
  • Hospitalization / economics*
  • Humans
  • Insurance, Health, Reimbursement / economics*
  • Intensive Care Units / economics
  • Length of Stay / economics
  • Male
  • Medicare Assignment / economics*
  • Medicare Part A / economics*
  • Medicare Part B
  • Quality Improvement / economics
  • Retrospective Studies
  • United States
  • Urinary Tract Infections / economics*
  • Urinary Tract Infections / mortality
  • Urinary Tract Infections / prevention & control