Key Facts
- Catheter-associated urinary tract infections (CAUTIs) entail an average of $1,000 in added care costs, but this cost can balloon to more than $10,000 depending on the patient’s care needs--and the costs to the hospital system for each CAUTI can climb higher than $22,000 per CAUTI.
- In the United States alone, CAUTIs account for $450 million in healthcare spending and 13,000 deaths annually, with as many as 500,000 CAUTIs occurring each year.
- 70% of UTIs are catheter-associated outside of intensive care settings, and 95% are catheter-associated in intensive care. Overall, CAUTIs account for more than 30% of all healthcare associated infections for hospitalized patients.
- CAUTIs are most often caused by bacteria entering the urinary tract due to an indwelling catheter, and external urinary collection devices (EUCDs) decrease the risk of CAUTIs.
Indwelling Catheters and the US Healthcare Market
Over 30 million indwelling catheters are sold annually in the United States, and up to 25% of all patients use an indwelling urinary catheter during their hospital stay according to the CDC. They are a critical part of inpatient and outpatient care but also incur significant risk for the patient. Catheter use duration can vary depending on a patient’s needs, but even short-term catheter use can last up to four weeks. This length of use, even in relatively shorter cases, offers a significant opportunity for sensitive tissues to be exposed to foreign bacteria. As such, catheter-associated urinary tract infections (CAUTIs) often occur due to bacteria entering the urinary tract during catheter use, from contact with the provider inserting the catheter, from natural buildup on the catheter itself, or improper maintenance during use.
Incidence of CAUTIs
On average, each day of catheter use increases a patient’s risk of contracting CAUTI by 3-7% according to the CDC. Annually, this accumulated risk amounts to an annual incidence of 500,000 CAUTIs in the United States, making them by far one of the most common healthcare associated infections. Rates of infection vary based on location and patient conditions but can be as high as 35.2 per 1000 catheter-days: a stark rate of infection when keeping in mind that many patients may be using their catheter for weeks or years. Standardized infection rates of CAUTIs have decreased in the last decade in acute care hospitals, but are increasing in long-term inpatient rehabilitation facilities, and still add up to hundreds of thousands of CAUTIs per year in inpatient care alone. CAUTIs are associated with a hospital stay extension by two to four days and increase the risk of developing other complications. As many as 13,000 people die in the US annually due to CAUTI-related complications.
The Cost of CAUTIs
Between the cost of extending a patient’s stay and added diagnosis, medication, and treatment, CAUTIs can radically increase healthcare costs. Most estimates place the average added cost to hospitals around $1000 in 2025 dollars, increasing to more than $10,000 in costs for pediatric and ICU patients with CAUTIs. This adds up to over $450 million in healthcare costs annually just to hospitals from CAUTIs, not considering the human cost of 13,000 annual deaths related to CAUTIs. Even beyond the costs specific to individual CAUTI cases, hospital systems incur penalties for having relatively higher infection rates. Taking these costs into account, estimates for the cost associated with each CAUTI ascend to a range of $5,000-$22,000.
Existing Solutions
The risk of a patient developing a CAUTI can be mitigated through regular maintenance of the indwelling catheter and limiting their use to when they are necessary, but the risk cannot be eliminated. As such, catheters occupy an unfortunate dual role in healthcare: they are both critical to the comfort and safety of a significant portion of both inpatient and outpatient care, and a risk factor that can endanger their patients, with that risk compounding the longer they are used. External urinary collection devices (EUCD) offer a promising alternative, though previously existing market alternatives show mixed results for reducing CAUTIs; while some studies show the potential for reducing rates of infection with existing market alternatives, the causality is unclear, and these differences could be the result of other protocol and care changes. Further prevention may be aided significantly by EUCD solutions that do not entail prolonged contact between the device and the urethra.
References:
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