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

Written by:
Yi SH, Baggs J, Gould CV, Scott RD 2nd, Jernigan JA.   Are you the author?
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA.

Reference: Med Care. 2014 Apr 1. Epub ahead of print.
doi: 10.1097/MLR.0000000000000106

PubMed Abstract
PMID: 24699236