Financial impact of surgical site infections on hospitals: The hospital management perspective

JAMA Surgery

Volumn 148, Issue 10, 2013, Pages 907-914

  Shepard, John ^a,e   Ward, William ^b   Milstone, Aaron ^c,d   Carlson, Taylor ^c   Frederick, John ^c   Hadhazy, Eric ^c   Perl, Trish ^a,d  

^a JOHNS HOPKINS UNIVERSITY   (United States)

^b JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH   (United States)

^c JOHNS HOPKINS HOSPITAL   (United States)

^d JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE   (United States)

^e STANFORD UNIVERSITY MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; HEALTH CARE COST; HEALTH CARE FINANCING; HOSPITAL MANAGEMENT; HOSPITAL READMISSION; HUMAN; LENGTH OF STAY; PRIORITY JOURNAL; PROFIT; SURGICAL INFECTION;

FEMALE; FINANCIAL MANAGEMENT, HOSPITAL; HOSPITAL CHARGES; HOSPITAL COSTS; HUMANS; INSURANCE, HEALTH; LENGTH OF STAY; MALE; MARYLAND; PATIENT READMISSION; RETROSPECTIVE STUDIES; SURGICAL WOUND INFECTION;

EID: 84886419459     PISSN: 21686254     EISSN: None     Source Type: Journal    
DOI: 10.1001/jamasurg.2013.2246     Document Type: Article

References (35)

1. A decade of evidence, design, and implementation: advancing patient safety. AHRQ website. http://www.ahrq.gov/professionals /quality-patient-safety/ patient-safety-resources /resources/advancing-patient-safety/index.html. Published 2009. Accessed February 1, 2012.
2. FastStats: inpatient surgery. CDC website. http://www.cdc.gov/nchs/ fastats/insurg.htm. Published 2011. Accessed June 5, 2011.
3. Burke JP. Infection control: a problem for patient safety. N Engl J Med. 2003;348(7):651-656. doi:10.1056/NEJMhpr020557.
4. Dimick JB,Weeks WB, Karia RJ, Das S, Campbell DA Jr. Who pays for poor surgical quality? building a business case for quality improvement. J AmColl Surg. 2006;202(6):933-937. doi:10.1016 /j.jamcollsurg.2006.02.015.
5. KilgoreM, Brossette S. Cost of bloodstream infections. Am J Infect Control. 2008;36(10):e1-e3. doi:10.1016/j.ajic.2008.10.004.
6. Roberts RR, Scott RD II, Hota B, et al. Costs attributable to healthcare-acquired infection in hospitalized adults and a comparison of economic methods. Med Care. 2010;48(11):1026-1035. doi:10.1097/MLR. 0b013e3181ef60a2.
7. Schulgen G, Kropec A, Kappstein I, Daschner F, Schumacher M. Estimation of extra hospital stay attributable to nosocomial infections: heterogeneity and timing of events. J Clin Epidemiol. 2000;53(4):409-417.
8. Graves N. Economics and preventing hospital-acquired infection. Emerg Infect Dis. 2004;10(4):561-566.
9. Graves N,McGowan JE Jr. Nosocomial infection, the Deficit Reduction Act, and incentives for hospitals. JAMA. 2008;300(13):1577-1579. doi:10.1001/jama. 300.13.1577.
10. Kirkland KB, Briggs JP, Trivette SL,Wilkinson WE, Sexton DJ. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol. 1999;20(11):725-730. doi:10.1086/501572.
11. Whitehouse JD, Friedman ND, Kirkland KB, RichardsonWJ, Sexton DJ. The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost. Infect Control Hosp Epidemiol. 2002;23(4):183-189. doi:10.1086/502033.
12. Graves N, Harbarth S, Beyersmann J, Barnett A, Halton K, Cooper B. Estimating the cost of health care-associated infections: mind your p's and q's. Clin Infect Dis. 2010;50(7):1017-1021. doi:10.1086/651110.
13. Engemann JJ, Carmeli Y, Cosgrove SE, et al. Adverse clinical and economic outcomes attributable tomethicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis. 2003;36(5):592-598. doi:10.1086/367653.
14. Vegas AA, Jodra VM, GarciaML. Nosocomial infection in surgery wards: a controlled study of increased duration of hospital stays and direct cost of hospitalization. Eur J Epidemiol. 1993;9(5):504-510.
15. Roberts RR, Scott RD II, Cordell R, et al. The use of economic modeling to determine the hospital costs associated with nosocomial infections. Clin Infect Dis. 2003;36(11):1424-1432.
16. de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: incidence and impact on hospital utilization and treatment costs. AmJ Infect Control. 2009;37(5):387-397. doi:10.1016 /j.ajic.2008.12.010.
17. Fraser VJ. Starting to learn about the costs of nosocomial infections in the new millennium: where do we go from here? Infect Control Hosp Epidemiol. 2002;23(4):174-176. doi:10.1086 /502031.
18. Herwaldt LA, Cullen JJ, Scholz D, et al. A prospective study of outcomes, healthcare resource utilization, and costs associated with postoperative nosocomial infections. Infect Control Hosp Epidemiol. 2006;27(12):1291-1298. doi:10.1086/509827.
19. Hollenbeak CS, Murphy D, DunaganWC, Fraser VJ. Nonrandom selection and the attributable cost of surgical-site infections. Infect Control Hosp Epidemiol. 2002;23(4):177-182. doi:10.1086 /502032.
20. Hollenbeak CS, Murphy DM, Koenig S, Woodward RS, DunaganWC, Fraser VJ. The clinical and economic impact of deep chest surgical site infections following coronary artery bypass graft surgery. Chest. 2000;118(2):397-402.
21. Jenney AW, Harrington GA, Russo PL, Spelman DW. Cost of surgical site infections following coronary artery bypass surgery. ANZ J Surg. 2001;71(11):662-664.
22. OlsenMA, Chu-Ongsakul S, Brandt KE, Dietz JR,Mayfield J, Fraser VJ. Hospital-associated costs due to surgical site infection after breast surgery. Arch Surg. 2008;143(1):53-60; discussion 61. doi:10.1001/archsurg.2007.11.
23. Olsen MA, Butler AM, Willers DM, Gross GA, Hamilton BH, Fraser VJ. Attributable costs of surgical site infection and endometritis after low transverse cesarean delivery. Infect Control Hosp Epidemiol. 2010;31(3):276-282. doi:10.1086 /650755.
24. Urban JA. Cost analysis of surgical site infections. Surg Infect (Larchmt). 2006;7(suppl 1):S19-S22. doi:10.1089/sur.2006.7.s1-19.
25. Weber WP, Zwahlen M, Reck S, et al. Economic burden of surgical site infections at a European university hospital. Infect Control Hosp Epidemiol. 2008;29(7):623-629. doi:10.1086/589331.
26. Zoutman D, McDonald S, Vethanayagan D. Total and attributable costs of surgical-wound infections at a Canadian tertiary-care center. Infect Control Hosp Epidemiol. 1998;19(4):254-259.
27. Fry DE. The economic costs of surgical site infection. Surg Infect (Larchmt). 2002;3(suppl 1):S37-S43. doi:10.1089/10962960260496325.
28. 3MHealth Information Systems; National Association of Children's Hospitals and Related Institutions, Inc; Medical Advisory Committee for NACHRI APR-DRG Research Project. All Patient Refined Diagnosis Related Groups (APR-DRGs) version 20.0:methodology overview. http://www .hcup-us.ahrq.gov/db/ nation/nis /APR-DRGsV20MethodologyOverviewand Bibliography.pdf. Published 2003. Accessed February 14, 2012.
29. Archived Producer Price Index detailed report information: December 2007, December 2008, December 2009, December 2010. US Bureau of Labor Statistics website. http://www.bls.gov/ppi /ppi-dr.htm. Published 2011. Accessed April 15, 2011.
30. Milstone AM, Maragakis LL, Townsend T, et al. Timing of preoperative antibiotic prophylaxis: a modifiable risk factor for deep surgical site infections after pediatric spinal fusion. Pediatr Infect Dis J. 2008;27(8):704-708. doi:10.1097/INF.0b013e31816fca72.
31. Centers for Disease Control and Prevention Division of Healthcare Quality Promotion; National Center for Emerging and Zoonotic Infectious Diseases. Surgical site infection (SSI) event. www.cdc.gov/nhsn/PDFs/pscManual /9pscSSIcurrent.pdf. Published 2010. Accessed January 20, 2011.
32. Maragakis LL, Cosgrove SE, Martinez EA, Tucker MG, Cohen DB, Perl TM. Intraoperative fraction of inspired oxygen is a modifiable risk factor for surgical site infection after spinal surgery. Anesthesiology. 2009;110(3):556-562.
33. Rauh SS,Wadsworth EB,Weeks WB,Weinstein JN. The savings illusion: why clinical quality improvement fails to deliver bottom-line results. N Engl J Med. 2011;365(26):e48. doi:10.1056 /NEJMp1111662.
34. Roberts RR, Frutos PW, Ciavarella GG, et al. Distribution of variable vs fixed costs of hospital care. JAMA. 1999;281(7):644-649.
35. Barnett AG, Beyersmann J, Allignol A, Rosenthal VD, Graves N,Wolkewitz M. The time-dependent bias and its effect on extra length of stay due to nosocomial infection. Value Health. 2011;14(2):381-386. doi:10.1016/j.jval.2010. 09.008.