The true cost of hospital-acquired infections

Subject: Science

Sec: Health

Context:

An orthopaedic surgeon and a well-known hospital from Mumbai are facing litigation due to a post-operative infection following a knee replacement surgery.
In another case from Bangalore, a patient who had been in the Intensive Care Unit (ICU) for over two weeks, ventilator-associated Acinetobacter pneumonia, a serious Hospital-Acquired Infection (HAI).

Hospital-Acquired Infection (HAI):

HAIs are infections that patients acquire while receiving treatment for medical or surgical conditions.
According to a study published by the International Nosocomial Infection Control Consortium (INICC), the prevalence of HAIs can be up to 20 times higher in low and middle-income countries compared to high-income areas.

Risk Factors:

Prevention Strategies:

Regular and proper handwashing by healthcare workers.
Use of sterile techniques during procedures and when handling catheters and IV lines.
Judicious use of antibiotics to prevent resistance.
Regular monitoring and reporting of infection rates to identify and address outbreaks.

Common Types

Surgical Site Infections (SSIs): Infections at the site of a surgical procedure.
Ventilator-Associated Pneumonia (VAP): Pneumonia that develops in patients on mechanical ventilation.
Catheter-Associated Urinary Tract Infections (CAUTIs): Infections linked to urinary catheters.
Central Line-Associated Bloodstream Infections (CLABSIs): Infections from central lines used for medication or fluid administration.

Country perspectives:

In the US, insurance system does not reimburse costs associated with certain HAIs. This policy incentivises hospitals to prevent such infections.
Also, Hospitals do not charge patients for the cost of managing HAIs, enhancing accountability.

Indian scenario:

India faces unique challenges due to its diverse healthcare standards and high levels of Anti-Microbial Resistance (AMR).
Despite many hospitals in India obtaining Joint Commission International (JCI) accreditation, a standard that upholds international healthcare quality, there is no obligation for these institutions to publicly disclose their HAI rates.
Though all NABH (National Accreditation Board for Hospitals) accredited hospitals generate the HAI quality indicator data on a monthly basis, they are not mandated to publicly disclose the data.

Proposed Solutions:

All NABH and JCI-accredited hospitals should be required to disclose their HAI rates on a common platform.
Hospitals should avoid charging patients for HAI treatments.
Creating awareness to distinguish between hospital-acquired and community-acquired infection.
Insurance companies could mandate that a portion of payouts be used to enhance infection control standards.