By Blaine Friedlander
November 3, 2015
In the war against MRSA, constructing single-patient rooms – rather than sick-bay style, multi-patient rooms – reduces hospital-acquired infections among patients. A new Cornell-led study finds that the purported high building costs of private hospital rooms are more than offset by the financial benefits of keeping patients safer from infection.
“We showed that although single-patient rooms are more costly to build and operate, they can result in substantial savings compared with open-bay rooms – all of this by avoiding costs associated with hospital-acquired infections,” said Hessam Sadatsafavi, Cornell postdoctoral researcher and lead author of the paper published in the Journal of Critical Care Oct. 27.
Hospital-acquired infections are the most common complication of hospital care in the U.S. and lead to extended hospital stays, ultimately increasing cost and risk of mortality. Recent health care reforms in the U.S. link Medicare reimbursements of hospital care to the performance of hospitals, including infection rates, and as a result, hospitals are vigilant to reduce incidents of acquired infections like MRSA (methicillin-resistant Staphylococcus aureus), Pseudomonas and Candida, the three most common – and most difficult to cure – infectious diseases in medical facilities.
The researchers compared costs of constructing single rooms or converting multi-patient rooms to private rooms, including subsequent annual operational costs, and then looked at the “internal rate of return” to assess the financial feasibility of the investment in private rooms. For investors, the internal rate of return must be acceptable – 10 percent, for example – to consider a capital project feasible. The researchers discovered that building new private rooms or private-room conversions made economic sense, as the internal rate of return – over a five-year analysis period – was 56.18 percent, considerably higher than any liberal estimates of rate of return acceptable by health care organizations.
While creating and operating larger private rooms from multi-patient rooms are expensive, said Sadatsafavi: “You have to spend additional money to treat the patients that acquired infection, as it would increase their hospital stay, and to contain the sickness – powerful cleaning supplies, support services. Single-patient ICU rooms reduce the cross-transmission rate and avoid extra medical costs to contain infection, and our research showed that these savings offsets capital costs.”
In the study Sadatsafavi explained that the researchers used a “probabilistic approach” to model unknown factors that affect clinical outcomes (infection risks and ICU occupancy rate) and financial outcomes, such as the cost of infections, construction and operating expenses. The probabilistic approach allows for quantifying investment risks and understanding the probability of achieving investment goals. It also provided a transparent framework that hospitals can use to evaluate the tradeoff between costs and benefits of private ICU rooms.
Co-authors were Bahar Niknejad, Hormozgan (Iran) University of Medical Sciences; Rana Zadeh, assistant professor, Cornell Department of Design and Environmental Analysis; and the first author’s brother Mohsen Sadatsafavi, assistant professor, Division of Respiratory Medicine, University of British Columbia, Vancouver, Canada.