Are we really seeing the total costs of surgical site infections? A Spanish study

Abstract

To identify overall costs generated by surgical site infections (SSI) patients, including indirect costs. A prospective study of case series of patients who have undergone major surgical treatment was undertaken. Patients who suffered SSI were compared with controls (nested case-control design). Centers for Disease Control and Prevention definitions were followed and SSI established. Overall costs and indirect related morbidity/mortality costs were estimated. The study was performed in a general, tertiary hospital (Valencia, Spain) for 4.5 years. Surgical site infections patients were 9.02% of the total people who underwent surgery. Their stays were prolonging by 14 days, and resources were used more intensely and for longer periods than in controls. Excess hospital costs were $10,232 per patient of which 37% corresponded to prolonged stays. Health costs only accounted for 10% of overall costs; $97,433 per patient including indirect social costs. Studies merely assessing excess costs due to prolonged stays of SSI patients do not reflect the entire scenario as they simply represent 35% of real hospital costs. A comprehensive appraisal shows that total healthcare expenditures represent a tenth of overall costs, which strengthens the claims that investment in preventing SSI would be highly cost-effective.

Economic Burden of Surgical Site Infections at a European University Hospital

“…Furthermore, we were unable to quantify any indirect costs, such as economic losses in connection with patients whose treatment had to be postponed as a consequence of the prolonged hospital stay of patients who developed SSI, or productivity-linked labor costs associated with patient sick leave. Alfonso et al 35 estimated that only 10% of the total costs of SSIs were healthcare-related costs; the remainder were social costs and labor-related costs.…”

Perioperative insulin therapy using a closed-loop artificial endocrine pancreas after hepatic resection

“…Total hospital costs were significantly lower for patients in the AP group than in the SS group (16 407 ± 5284 $ vs 21 879 ± 15 784 $, respectively, P = 0.047). There is evidence suggesting that SSI prolongs the length of hospitalization for patients undergoing cardiac surgery, caesarean section, orthopedic surgery and general surgery, and increases the total costs of a patient's treatment [28] . These results support the notion that intensive insulin therapy using a closed-loop glycemic control system after hepatic resection results in the maintenance of near normoglycemia, contributing to a reduction in both the incidence of SSI and total hospital costs per patient due to a decreased duration of hospitalization.…”

Management and cost of surgical site infection in patients undergoing surgery for spinal metastasis

“…the potential of surgical failure leading to spinal instability, significant pain, loss of sensory and motor function and disability). Previously it has been estimated that healthcare costs only account for 10% of the overall costs of SSI to the wider economy, 22 which would include loss of earnings of patients and carers, and reductions in productivity through absence from work. 21 Ways of reducing the number of SSIs occurring in the first instance are therefore highly desirable.…”