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Predict Urinary Tract Infections

Urinary tract infections (UTIs) impose significant health and financial burdens, AI allows providers to intervene accordingly

Problem

Urinary tract infections (UTIs) are the most common infections treated in outpatient settings in the United States (1). UTIs are also the fifth most common type of hospital-acquired infection, with an estimated 62,000 infections occurring annually in acute care hospitals (2). Each year, UTIs are responsible for approximately 400,000 hospitalizations, an estimated seven million office visits, and one million ED visits, resulting in roughly $10 billion in expenditures related to UTI care (3).

Size of the Problem

  • $10 billion is the estimated cost associated with UTI care in the U.S. annually (3).
  • 13,000 deaths are associated with healthcare-acquired UTIs each year (2).
  • 69% of CAUTIs are considered to be avoidable (6).

Why it matters

UTIs can lead to serious complications, especially for older adults, and may also be difficult to distinguish from asymptomatic bacteriuria (ASB). Catheter-associated urinary tract infections (CAUTIs) can lead to prolonged length of stay, sepsis, and increased costs and mortality. Annually, more than 13,000 deaths are associated with healthcare-acquired UTIs (2). Differentiating UTIs from ASB in older adults is challenging, as ASB is estimated to be found in up to 16% of women older than 65 (4). In long-term care facilities (LTCs), ASB prevalence may be as high as 50% (4). ASB also remains a common reason antibiotics are prescribed, but studies have indicated that up to 75% of antimicrobial use is inappropriate (4). This potential overutilization of antibiotics can lead to serious complications (e.g. C. difficile infection).

Solution

UTIs impose significant health and financial burdens, but providers can employ predictive analytics to proactively identify individual patients at high risk for UTIs and intervene accordingly. These interventions may be especially important for older adults who are at increased risk for complications due to overuse of antibiotics. UTI interventions may include encouraging sufficient fluid intake, promoting genital and urinary hygiene, and the use of low-dose vaginal estrogen cream (5). Removal of indwelling catheters without clear urological need can also prevent CAUTIs. 69% of CAUTIs are considered avoidable, and interventions based on decreasing utilization have been proven to reduce CAUTI incidence by 50% in acute care settings (6).

Datasources

  • Medical Claims: Data extracted from health insurance medical claims with details about dates and place of service, diagnosis codes, key procedures, use of medical equipment, and provider specialties.
  • Lab Test Results: Data about important risk markers from tests used for diagnosis, monitoring therapy, or screening, with details about specific results and abnormal indicators.
  • Social Determinants of Health (SDoH): Geo-centric data with details about the social and environmental influences on people’s health and outcomes.

Citations

  1. Medina, Martha, and Edgardo Castillo-Pino. “An Introduction to the Epidemiology and Burden of Urinary Tract Infections” Therapeutic Advances in Urology, vol. 11, 1 Jan. 2019, doi:10.1177/1756287219832172. Accessed 5 Mar. 2021.
  2. Centers for Disease Control and Prevention. “Urinary Tract Infection (Catheter-Associated Urinary Tract Infection [CAUTI] and Non- Catheter-Associated Urinary Tract Infection [UTI] Events.” National Healthcare Safety Network, Jan. 2021. Accessed 5 Mar. 2021.
  3. Simmering, Jacob E., et al. The Increase in Hospitalizations for Urinary Tract Infections and the Associated Costs in the United States, 1998-2011. Open Forum Infectious Diseases, vol. 4, no. 1, 1 Jan. 2017, doi:10.1093/ofid/ofw281. Accessed 8 Mar. 2021.
  4. Rowe, Theresa A, and Manisha Juthani-Mehta. “Urinary Tract Infection in Older Adults." Aging Health, vol. 9, no. 5, Oct. 2013, pp. 519-528, 10.2217/ahe.13.38.
  5. Family Health Team. “6 Things You Should Know about UTIs in Older Adults.” Health Essentials from Cleveland Clinic, Health Essentials from Cleveland Clinic, 4 May 2018, health.clevelandclinic.org/6-things-you-should-know-about-utis-in-older-adults/. Accessed 23 Feb. 2021.
  6. Meddings, Jennifer, et al. “Systematic Review of Interventions to Reduce Urinary Tract Infection in Nursing Home Residents” Journal of Hospital Medicine, vol. 12, no. 5, 1 May 2017, pp. 356-368, doi:10.12788/jhm.2724. Accessed 8 Mar. 2021.

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