title: 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.
authors.affiliation: Quality Assurance and Preventive Medicine Service, and Department of Preventive Medicine, University of Valencia, Valencia, Spain. jose.l.alfonso@uv.es
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Alfonso
authors.forename: Sergio Blasco
authors.initials: SB
authors.lastname: Pereperez
authors.forename: Jose Moreno
authors.initials: JM
authors.lastname: Canoves
authors.forename: Mercedes Melgar
authors.initials: MM
authors.lastname: Martinez
authors.forename: Isabel Martinez
authors.initials: IM
authors.lastname: Martinez
authors.forename: Jose M
authors.initials: JM
authors.lastname: Martin-Moreno
mesh_terms: D017281:Cost of Illness; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics; D013030:Spain; D013530:Surgical Wound Infection / Q000191:economics*