Unveiling the unseen: the hidden costs of health care-associated infections

Many aspects of health care-associated infections are unseen. The bacteria that cause infections like C. difficile or catheter-associated urinary tract infections are invisible to the naked eye. Beyond the financial burdens of additional treatment and longer hospital stays, less obvious costs often fall below the radar in the form of suffering, distress, and shattered trust in the health care system when patients fall victim to preventable infections.

And, often low profile and behind the scenes, health care epidemiologists and infection preventionists lead the prevention efforts against health care-associated infections. Health care epidemiologists are crucial to the safe functioning of every hospital and health system and should be considered valuable allies to the C-suite.

These professionals investigate pathogens and the workflow processes of health care personnel to uncover hidden reservoirs of bacteria and paths of transmission. They work with a multidisciplinary team to identify threats before they spread. This includes working with engineers and plumbers to prevent outbreaks from microbes hiding in sink traps. They also support operations and staff at all levels to ensure hand hygiene supplies are accessible and health care personnel follow the policies and processes for hand hygiene. They work closely with housekeeping and environmental services to ensure microbes do not spread from high-touch surfaces such as bedrails and doorknobs to patients, visitors, and staff.

Health care-associated infections cost the U.S. health care system billions of dollars every year. In our rapidly evolving health care landscape, with fast-paced technological innovations, the prevention of health care-associated infections remains one of the most pressing and overlooked challenges. Infections acquired within a health care setting pose a significant threat to patient well-being and can lead to physical, emotional, and financial burdens impacting not only individual patients but their families and communities.

While the costs of health care-associated infections are well-documented, prevention yields undeniable financial savings as well as patient and societal benefits. For example, urinary tract infections linked to catheter use are one of the most common and costly preventable infections in health care. Patients grappling with catheter-associated urinary tract infections may experience prolonged physical suffering and emotional distress. They require additional treatments and longer hospital stays, and their trust in the health care system can be shattered, influencing future health care-seeking behavior.

Multidrug-resistant organisms introduce another layer of complexity. For a patient who contracts an antibiotic-resistant strain while hospitalized, the limited treatment options due to drug resistance extend the duration of illness and increase the likelihood of complications, compounding the full financial toll on the health care system and the physical and emotional toll on patients.

Preventing health care-associated infections requires special training in infectious diseases, an understanding of microbes’ interactions with the host, and an understanding of how people—patients, visitors, and staff—intermingle within a health care facility’s built environment.

Investing in a knowledgeable health care workforce that can bring prevention to every aspect of the health care operation is crucial. Health care professionals well-versed in principles and practices of infection control establish processes to remove or prevent the use of unnecessary medical devices, such as urinary catheters, that can cause infection; track down multidrug-resistant organisms, and teach everyone from nursing staff to cafeteria aides how to avoid spreading the bacteria that cause deadly infections.

The time to invest in prevention isn’t when we are deep in a pandemic or reacting to a local outbreak, but instead when we are in our regular health care business status quo. Investing in outbreak prevention through health care epidemiology isn’t just about saving money; it’s about saving lives. When health care professionals are armed with the knowledge and expertise to prevent infections, they become a formidable barrier against the unseen costs of HAIs.

Trini Mathew is an infectious disease physician.


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