Amer J Perinatol 2013; 30(03): 179-184
DOI: 10.1055/s-0032-1322516
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Investment Case for Preventing NICU-Associated Infections

Edward F. Donovan
Ohio Perinatal Quality Collaborative Executive Committee and James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
Karen Sparling
Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
Michael R. Lake
Budget and Financial Integrity, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
Vivek Narendran
Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
University Hospital, Cincinnati, Ohio
,
Kurt Schibler
Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
Good Samaritan Hospital, Cincinnati, Ohio
,
Beth Haberman
Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
Barbara Rose
Ohio Perinatal Quality Collaborative Executive Committee and James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
Jareen Meinzen-Derr
Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
,
on behalf of the Ohio Perinatal Quality Collaborative› Author Affiliations
Further Information

Publication History

29 February 2012

16 March 2012

Publication Date:
26 July 2012 (eFirst)

Abstract

Background Nosocomial [hospital-associated or neonatal intensive care unit (NICU)-associated] infections occur in as many as 10 to 36% of very low-birth-weight infants cared for in NICUs.

Objective To determine the potentially avoidable, incremental costs of care associated with NICU-associated bloodstream infections.

Study Design This retrospective study included all NICU admissions of infants weighing 401 to 1500 g at birth in the greater Cincinnati region from January 1, 2005, through December 31, 2007. Nonphysician costs of care were compared between infants who developed at least one bacterial bloodstream infection prior to NICU discharge or death and infants who did not. Costs were adjusted for clinical and demographic characteristics that are present in the first 3 days of life and are known associates of infection.

Results Among 900 study infants with no congenital anomaly and no major surgery, 82 (9.1%) developed at least one bacterial bloodstream infection. On average, the cost of NICU care was $16,800 greater per infant who experienced NICU-associated bloodstream infection.

Conclusion Potentially avoidable costs of care associated with bloodstream infection can be used to justify investments in the reliable implementation of evidence-based interventions designed to prevent these infections.