Could the prevention of health care-associated infections increase hospital cost? The financial impact of health care-associated infections from a hospital management perspective

Am J Infect Control. 2020 Mar;48(3):255-260. doi: 10.1016/j.ajic.2019.08.035.


Background: The financial burden health care-associated infections (HAIs) have on patients, payers, and hospitals is not clear. Although patient safety is the highest priority, administrators require data to justify the expense of HAI reduction programs.

Methods: Chart review was performed to identify HAIs for patients discharged from Stanford Hospital. Using a t test, we tested whether patients with an HAI will have a different daily total hospital cost and length of stay than patients without an HAI. We calculated the change in hospital profit related to HAIs by comparing patients with and without an HAI in the same admit All-Patient Refined Diagnosis Related Group and complexity score.

Results: Between October 1, 2015 and September 30, 2018, there were 78,551 inpatient discharges and 1,541 HAIs identified. Daily total hospital cost and length of stay for patients with an HAI versus patients without an HAI was $6,433 ($6,251, $6,615) versus $6,604 ($6,557, $6,651) (P = .073), and 26.30 days (24.89, 27.71) versus 5.69 (5.64, 5.74) (P < .001).

Discussion: For each HAI eliminated, data suggests that hospital's cost and revenue would increase $25,008 and $1,518,682, respectively, by backfilling beds with new patients at a 4.62:1 ratio. The reduction of HAIs is profitable for hospitals.

Conclusions: Data from this study suggest that the more HAIs you eliminate and the more capacity you build for the hospital, the higher the total hospital costs will go. This is an essential shift to the current paradigm that will allow for the accurate and continued funding of HAI reduction programs. Although hospital cost appears to increase as HAIs are reduced, hospital profits rise even more.

Keywords: Business planning; Infection control; Quality; Return on investment; Revenue.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross Infection / economics*
  • Female
  • Hospital Costs*
  • Hospitalization / economics*
  • Hospitals
  • Humans
  • Inpatients
  • Intensive Care Units / economics
  • Length of Stay / economics
  • Male