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Estimated costs of postoperative wound infections

A case-control study of marginal hospital and social security costs

Published online by Cambridge University Press:  15 May 2009

K. B. Poulsen ,
A. Bremmelgaard ,
A. I. Sørensen ,
D. Raahave  and
J. V. Petersen
K. B. Poulsen*
Affiliation:
The National Center for Hospital Hygiene, Statens Seruminstitut
A. Bremmelgaard
Affiliation:
Department of Clinical Microbiology, Frederiksberg Hospital
A. I. Sørensen
Affiliation:
Department of Orthopaedic Surgery, Frederiksberg Hospital
D. Raahave
Affiliation:
Department of General Surgery, Frederiksberg Hospital
J. V. Petersen
Affiliation:
EDP-department, Frederiksberg Hospital
*
* Author responsible for Correspondence and reprints: Kjeld B. Poulsen, The National Center for Hospital Hygiene, Statens Seruminstitut, Artillerivej 5, DK-2300 Copenhagen S, Denmark.
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Summary

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A cohort of 4515 surgical patients in ten selected intervention groups was followed. Three hundred and seventeen developed postoperative wound infections, and 291 of these cases were matched 1:1 to controls by operation, sex and age. In comparison to the controls the cases stayed longer in hospital after the intervention and had more contact after discharge with the social security system.

Using data from a national sentinel reference database of the incidence of postoperative wound infections, and using national activity data, we established an empirical cost model based on the estimated marginal costs of hospital resources and social sick pay. It showed that the hospital resources spent on the ten groups, which represent half of the postoperative wound infections in Denmark, amounted to approximately 0·5% of the annual national hospital budget. This stratified model creates a better basis for selecting groups of operations which need priority in terms of preventive measures.

Type
Research Article
Information
Epidemiology & Infection , Volume 113 , Issue 2 , October 1994 , pp. 283 - 295
Copyright
Copyright © Cambridge University Press 1994

References

REFERENCES

1.Kjellgren, K, Norberg, B, Fryklund, B, Burman, LGRegistrering av kirurgiska infektioner kan “spara” mångmiljonbelop i vården. [Registration of surgical wound infections can “save” many millions in the clinic]. Läkartidningen 1985; 82: 4428–31.Google Scholar
2.Jepsen, OBInfektioner efter operationer sluger sengedage. [Infections after surgery consume bed days]. Journal 1990; 2: 17.Google Scholar
3.OECD. Health care systems in transitions. The search for efficiency, Paris: OECD, 1990.Google Scholar
4.Poulsen, KBSkildvagtssygehuse. En national referencedatabase til registrering af postoperative sårinfektioner. [Sentinel hospitals. A national reference database for registration of postoperative wound infections]. Statens Seruminstitut 1993; vol 1–3.Google Scholar
5.Bremmelgaard, A, Sørensen, AMI, Brems-Dalgaard, E, Raahave, D, Pedersen, JVFire års erfaringer med edb-registrering af postoperative sårinfektioner og identifikation af risikofaktorer. [Four years of experience with EDP-recording of postoperative wound infections and identification of risk factors]. Ugeskr Laeger 1991; 153: 1416–9.Google Scholar
6.Olson, MM, Lee, JTContinuous, 10-year wound infection surveillance. Arch Surg 1990; 125: 794–803.Google Scholar
7.Bremmelgaard, A, Raahave, D, Holgersen, R, Pedersen, JV, Andersen, S, Sørensen, AComputer-aided surveillance of surgical infections and identification of risk factors. J Hosp Infect 1989: 13: 1–18.Google Scholar
8.Boel, J, Sinding, AData registering af postoperative sårinfektioner på en ortopædkirurgisk afdeling. [EDP-recording of postoperative wound infections in an ortopaedic ward]. Nord Med 1988; 103: 135–7.Google Scholar
9.Penin, GB, Ehrenkrantz, NJPriorities for surveillance and cost-effectiveness control of postoperative infection. Arch Surg 1988; 123: 1305–8.CrossRefGoogle Scholar
10.Boyce, JM, Potter, BG, Dziobek, LHospital reimbursement patterns among patients with surgical wound infections following open heart surgery. Infect Control Hosp Epidemiol 1990; 11: 89–93.CrossRefGoogle ScholarPubMed
11.Jensen, JP, Noer, HH, Waadegaard, M, Lund, FKontinuerlig overvågning af sårinfektioner og andre postoperative komplikationer med anvendelse af MIKROORT. [Continuous surveillance of wound infections and other postoperative complications by the use of the EDP-programme MIKROORT]. Ugeskr Laeger 1990; 152: 2106–10.Google ScholarPubMed
12.Greiff, JOmkostningerne ved en inficeret crusfraktur. [The costs of an infected fracture of the crus]. Ugeskr Laeger 1980; 142: 1828.Google Scholar
13.Haley, RW, Schaberg, DR, Allmen, SD, McGowan, JEEstimation of the extra charges and prolongation of the hospitalization due to nosocomial infections: A comparison of methods. J Infect Dis 1980; 141: 248–57.Google Scholar
14.Mooney, GEconomics, medicine and health care, 2nd ed.New York: Harvester Wheatsheaf, 1992.Google Scholar
15.OECD. Financing and delivering health care. A comparative analysis of OECD countries, Paris: OECD, 1987.Google Scholar
16.Wakefield, DS Understanding the costs of nosocomial infections. In: Wenzel, RP, ed. Prevention and control of nosocomial infections, Baltimore: Williams & Wilkins, 1992, p. 21–41.Google Scholar
17.Davies, TW, Cottingham, JThe cost of hospital infection in orthopaedic patients. J Infect 1979; 1: 329–38.Google Scholar
18.Fabry, J, Meynet, R, Joron, MT, Sepetjan, M, Lambert, DC, Guillet, RCost of nosocomial infections: Analysis of 512 digestive surgery patients. World J Surg 1982; 6: 362–5.Google Scholar
19.Schafer, UKostenanalyse bei nosokomialen infektionen. Eine einjährige studie in der chirurgischen abteilung des kreiskrankenhauses, Riesa. [A cost analysis of nosocomial infections. A one-year study in the surgery department of the hospital in Riesa]. Zentralbl Chir 1987; 112: 1552–60.Google Scholar
20.Stürup, J, Sørensen, TS, Tørholm, C, Jensen, JSRessourceforbruget forbundet med inficerede hofteoperationer. [The resources connected to infected operations on the hip]. Ugeskr Laeger 1988; 150: 1147–8.Google Scholar
21.Den centrale afdeling for sygehushygiejne. Råd & anvisninger om registrering af postoperative sårinfektioner. [Guidelines on the registration of postoperative wound infections], Copenhagen: Statens Seruminstitut, 1988.Google Scholar
22.Solstad, K Forsøk med stykprisfinansiering. Prisliste. [Experiments with retail pricing. Price list]. Norsk Institut for Sykehusforskning, Trondheim: Rapportnummer STF 81 A90020. 1985.Google Scholar
23.Slåttebrekk, OV Hva koster pasienten? En beregning af norske kostnadsvekter til DRG. [What does the patient cost? A calculation of the Norwegian cost weights for DRG]. Norsk Institut for Sykehusforskning, Trondheim: Rapportnummer STF 81 A90003, 1990.Google Scholar
24.Aas, HM DRG: Diagnose Relaterte Grupper. En litteraturoversikt. [DRG: Diagnose related Groups. A review of the literature], Norsk Institut for Sykehusforskning, Trondheim: Rapportnummer STF 81 A85003, 1985.Google Scholar
25.Alban, A (ed). Produktivitets- og effektivitetsmåling på sygehuse. Erfaringer fra et EF-projekt om omkostningsmodeller og case-mix. [Productivity- and effectivity measurements on hospitals. Experiences from a EEC-project concerning cost models and case-mix]. Dansk Sygehus Institut. Copenhagen 1991.Google Scholar
26.Andersen, B, Knudsen, MSProduktivitets- og effektivitetsmåling på sygehuse. Omkostningsmodeller i parksis. [Productivity- and effectivity measurements on hospitals. Costmodels from praxis]. Dansk Sygehus Institut 1994.Google Scholar
27.Danmarks Statistik. Statistisk årbog 1993. 97th ed. [Statistical yearbook 1993], Copenhagen: Danmarks Statistik. 1993.Google Scholar
28.Københavns Statistiske Kontor. Statistisk årbog for København og Frederiksberg samt Hovedstadsregionen. [The statistical year-book for Copenhagen and Frederiksberg and the capital region], Copenhagen: Københavns Statistiske Kontor, 1987.Google Scholar
29.Poulsen, KB, Jepsen, OB, Recording of postoperative wound infections in Denmark. Implementation, surgeon attitude, status and recommendations. DMB 1992; 39: 467–70.Google Scholar
30. Amtsrådsforeningen. Amterne i tal 92. Social- og sundhedssektoren. [The counties in numbers 92. Social and health sectors], Copenhagen: Amtsradsforeningen, 1993.Google Scholar
31.Cruse, PJE, Foord, RThe epidemiology of wound infections. A 10-year study of 62,939 wounds. Surg Clin N Am 1980; 60: 27–40.Google Scholar
32.Thorup, J, Jepsen, OB, Birch, C, Kvist, EInfektioner i kirurgisk og gynækologisk-obstetrisk afdeling. [Infections in a surgical and gvnaecological department]. Ugeskr Laeger 1981; 143: 1815–9.Google Scholar
33.Green, JW, Wenzel, RPPostoperative wound infection: A controlled study of the increased duration of hospital stay and direct cost of hospitalization. Ann Surg 1977; 185: 264–8.Google Scholar
34.Nelson, RM, Dries, DJThe economic implications of infection in cardiac surgery. Ann Thorac Surg 1986; 42: 240–6.Google Scholar
35.Losos, J, Trotman, MEstimated economic burden of nosocomial infection. Can J Public Health 1984: 75: 248–50.Google Scholar
36.Wakefield, DS, Pfaller, M, Ludke, RL, Wentzel, RPMethods for estimating days of hospitalization due to nosocomial infections. Med Care 1992; 30: 373–6.Google Scholar
37.Sørensen, AMI, Brerns-Dalgaard, E, Bremmelgaard, A, Raahave, D, Pedersen, JPVanskeligheder ved kontinuerlig edb-registrering af postoperative sårinfektioner. [Difficulties connected with EDP-recording of postoperative wound infections]. Ugeskr Laeger 1991; 153: 1420–2.Google Scholar
38.Ayliffe, GAJNosocomial infection – The irreducible minimum. Infect Contr 1986: 7(2 suppl): 92–5.Google Scholar
39.Haley, RW Managing hospital infection control for cost-effectiveness. A strategy for reducing infectious complications, American Hospital Publishing, 1986.Google Scholar