When considering an infection prevention intervention, how should the costs be calculated? The first question should be what costs should be calculated? With the myriad of direct, indirect, and intangible costs related to HAIs, where is a facility to start? There are several types of costs to be taken into consideration, and each type will come from different sources. In this post, we will explore how a facility may collect cost data when evaluating a potential new infection intervention.
Any time a healthcare facility considers investing in a new intervention - a medicine, a device, a piece of equipment, and even a training program - one of the first considerations will be cost effectiveness. The facility has a responsibility, both financial and ethical, to weigh the cost of an investment with the likelihood and extent of patient benefits. We would all love to live in a world where hospitals could invest in any and all interventions without thought as to cost and return on investment. Instead, we face a reality in which not only are financial resources limited, but also personnel, space, and even time are constrained. As a result, when millions of dollars and patients' lives are at stake, calculating cost effectiveness of an intervention has a lot on the line.
Our previous post presented some of the problems with the current fee-for-service payment model used in healthcare. In response to these costly problems, there are a number of alternative payment models being tested, with promising results. Today we will look at the alternatives that seem to be picking up speed as we move toward reducing our nation's healthcare costs.
As hard as it is to believe, most hospitals do not know how much their services cost. They know what they charge, but that number has almost nothing to do with what individual services actually cost them as providers. This is about to change. With shockingly rising healthcare costs (17% of our gross national product, and rising at 4% per year) and frighteningly shrinking coffers with which to pay for it, there is a growing movement to move from fee-for-service payment models to alternative value-based payments. As we move towards these new cost-reducing models, what will be the impact on infection control?
The Wall Street Journal addressed the growing concern over infection control in America's nursing homes, citing research from a recent paper from the Columbia School of Nursing. The article summarizes the four key obstacles to effective infection control in nursing homes: Overuse of antibiotics, inadequate staff/training, lack of resources, and a lack of data/surveillance. In this series of posts, we will explore the nursing home landscape, investigating the origin of and solution to each of those four obstacles. Today we start with an overview of nursing homes.
