title: Extra charge and extra length of postoperative stay attributable to surgical site infection in six selected operations.
abstract: BACKGROUND
  Information concerning the economic impact of surgical site infection (SSI) is very rare in Thailand. As the national health care financial system has been changing, the need for such data is critical.
  
  
  OBJECTIVE
  The purpose of this study is to estimate the extra charge and excess postoperative hospitalization attributable to SSI in six surgical operative procedures comprising appendectomy, herniorrhaphy, mastectomy, cholecystectomy, colectomy, and craniotomy.
  
  
  METHODS
  The study population consisted of patients undergoing major operations admitted to Songklanagarind Hospital from January, 1998 to December, 2003. Data were prospectively collected to identify demographic data, surgical operations, development of SSI, and outcomes of SSI. The study used one-to-one matched-pair strategy to compare case (patient with SSI) and controls (patient without SSI). The matching criteria were same final diagnosis, same operative procedure, and same American Society of Anesthesiologists (ASA) score. Data were calculated for mean difference, median difference, and 95% confidence intervals (95% C.I) of hospital charge and postoperative stay.
  
  
  RESULTS
  The study could identify 140 matched-pairs of case and control. When compared to matched controls, cases had higher hospital charge and greater postoperative length of stay. Mean of extra hospital charge attributable to SSI was 43,658 (95% C.I; 30,228-57,088) baht and mean of excess postoperative stay was 21.3 (95% C.I; 16.6-26.0) days. Median of extra expenditure was 31,140 (95% CI; 17,327-49,081) baht and median of prolongation of postoperative stay was 14 (95% C.I, 12-18) days.
  
  
  CONCLUSIONS
  This study supports the findings of the previous published reports that patients who have SSI incur enormous excess cost and hospital stay.
authors.affiliation: Faculty of Nursing, Chiang Mai University, Chiang Mai 50200, Thailand. nongyaok2003@yahoo.com
authors.forename: Nongyao
authors.initials: N
authors.lastname: Kasatpibal
authors.forename: Somchit
authors.initials: S
authors.lastname: Thongpiyapoom
authors.forename: Montha Na
authors.initials: MN
authors.lastname: Narong
authors.forename: Nonglak
authors.initials: N
authors.lastname: Suwalak
authors.forename: Silom
authors.initials: S
authors.lastname: Jamulitrat
mesh_terms: D016022:Case-Control Studies; D005260:Female; D017722:Hospital Charges; D006779:Hospitals, Public / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics*; D008297:Male; D011184:Postoperative Period; D011446:Prospective Studies; D012307:Risk Factors; D018571:Sentinel Surveillance; D013530:Surgical Wound Infection / Q000150:complications / Q000191:economics* / Q000453:epidemiology; D013785:Thailand; D013997:Time Factors