Estimating the savings of a national project to prevent healthcare-associated infections in intensive care units.

Healthcare-associated infections (HAIs) significantly impact patients’ morbidity and mortality and have a detrimental financial impact on the health care system. Various strategies exist to prevent HAIs, but economic evaluations are needed to choose which are most appropriate.
To present the financial impact of a nationwide project on HAI prevention in intensive care units (ICUs) using a quality improvement (QI) approach.
A health economic evaluation assessed the financial results of the QI initiative “Saúde em Nossas Mãos” (SNM), implemented in Brazil between January 2018 and December 2020. Among 116 participating institutions, 13 (11.2%) correctly reported the aggregate cost and stratified patients (with vs. without HAI) in the pre-intervention and post-intervention periods. Average cost (AC) was calculated for each analysed HAI, central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infection (CAUTI). The absorption model and time-driven activity-based costing were used for cost estimations. Infections the project could have prevented during its implementation were estimated to demonstrate the financial impact of the SNM initiative.
The aggregated AC calculated for each HAI from these 13 ICUs – US$8,480 for CLABSI, US$10,039 for VAP, and US$7,464 for CAUTI – were extrapolated to the total number of HAIs prevented by the project (1,727 CLABSI, 3,797 VAP, and 2,150 CAUTI). The overall savings of the SNM as of December 2020 were estimated at US$68.8 million, with an estimated return on investment (ROI) of 765%.
Reporting accurate financial data on HAI prevention strategies is still challenging in Brazil. Our results suggest that a national QI initiative to prevent HAI in critical care settings is a feasible and value-based approach, reducing financial waste and yielding a significant ROI for the health care system.
Copyright © 2023. Published by Elsevier Ltd.