UTI Overview

 

Urinary tract infections (UTIs) affect millions of people each year and rank as the second most common type of body infection. Women are more likely than men to get a urinary tract infection than men, but when they occur in men they can be very serious. Up to 50 percent of women will develop at least one UTI in their life time and some will experience several. UTIs account for over 8 million doctor visits a year.

 

Catheter associated urinary tract infections (CAUTIs) are the most common nosocomial (acute care and extended care facilities) infection. They are costly and potentially lethal. CAUTIs account for approximately 40 percent of all nosocomial infections.

 

Urinary catheters are inserted in more than 5 million patients per year. One out of four hospitalized patients will have a urinary catheter placed during their hospital stay.

 

Beginning October 1, 2008, the Centers for Medicare and Medicaid Services (CMS) will no longer provide reimbursement over and above the typical Inpatient Prospective Payment System (IPPS) rate for care required to battle several types of healthcare-associated infection, also referred to as hospital-acquired infection (HAI).

 

CMS collaborated with the Centers for Disease Control and Prevention and other healthcare groups to identify a number of hospital-acquired conditions that were high volume, high cost, or both, and “could reasonably have been prevented through the application of evidence-based guidelines,” as mandated by Section 5001(c) of the Deficit Reduction Act.

 

The final rule states that hospitals “will not receive additional payment for cases in which one of the selected conditions was not present on admission. That is, the case will be paid as though the secondary diagnosis was not present.”

 

Costs & Reimbursement:

 

  • A single incident of CAUTI (catheter associated urinary tract infection) will add $500 to $1,000 to the direct costs of acute-care hospitalization.
  • CAUTI is the second most common cause of nosocomial bloodstream infection.
  • CAUTIs are associated with substantially increased institutional death rates.
  • Protected or medicated urinary catheters reduce the adherence of microorganisms to the catheter surface and may confer benefit for preventing CAUTI.*

    * Selection of antimicrobial-drug resistant uropathogens was not satisfactorily resolved.

 

References:

 

Maki DG. Tambyah PA. Engineering out the risk of infection with urinary catheters. Emerging Infectious Diseases. Vol 7, No. 2, March-April 2001.

 

Ambulatory Care Visits to Physician Offices, Hospital Outpatient Departments, and Emergency Departments: United States, 1999-2000. Vital and Health Statistics.
Series 13, No. 157. Hyattsville, MD: National Center for Health Statistics, Centers for Disease Control and Prevention, U.S. Dept. of Health and Human Services; September 2004.

 

http://kidney.niddk.nih.gov/kudiseases/pubs/utiadult/

 

http://kidney.niddk.nih.gov/kudiseases/pubs/kustats/index.htm

 

Kalsi J. Arya M. Willson P. Mundy A. Hospital-acquired urinary tract infection. Int J Clin Pract. 2003 Jun;57(5):388-91.