title: Acute surgical treatment of cutaneous abscesses: cost savings from prioritisation in theatre.
abstract: BACKGROUND
  Treatment of cutaneous abscesses is an important part of the acute surgical workload and most are treated with incision and drainage. Traditionally most are treated after major cases in theatre prioritisation and remain in hospital overnight.
  
  
  OBJECTIVE
  To examine the cost saved in patients after drainage of skin abscesses according to the time of surgery ('am' versus 'pm').
  
  
  METHODS
  The clinical records of all patients who underwent acute incision and drainage of cutaneous abscesses at North Shore Hospital (Takapuna, Auckland, New Zealand) between 1 June-31 December 2011 were reviewed with respect to the time of day when surgery was performed [am (defined as 0730-12 noon of the day of surgery)] versus pm). Costs were calculated using standard tariffs set by our hospital.
  
  
  RESULTS
  339 patients (median age 34 yr, 164 female) were admitted for acute drainage of cutaneous abscesses with 149 operated in "am". There was no difference in patients undergoing am versus pm drainage in terms of age, sex, race, Charlson comorbidity score or smoking status although diabetic patients were more likely to undergo a pm drainage (p=0.008). The median cost per discharge was NZ$2397.39. The cost of the 'am' group was significantly less compared to the cost of the 'pm' group with NZ$2236.63 compared to NZ$2531.70 (p=0.0034) and saved a median of NZ$295.07 per patient. This amounted to the cost of an overnight bed stay.
  
  
  CONCLUSIONS
  Prioritisation of abscess drainage in acute theatre management is safe and associated with significant cost savings.
authors.forename: Vincent
authors.initials: V
authors.lastname: Chong
authors.forename: Lifeng
authors.initials: L
authors.lastname: Zhou
authors.forename: Hardeep
authors.initials: H
authors.lastname: Hundal
authors.affiliation: The Department of Surgery, North Shore Hospital, Private Bag 93503, Takapuna, Auckland, New Zealand. jonathan.koea@waitematadhb.govt.nz.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Koea
mesh_terms: D000038:Abscess / Q000191:economics* / Q000601:surgery*; D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000191:economics*; D017046:Cost Savings; D004322:Drainage / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009520:New Zealand; D010343:Patient Admission / Q000191:economics*; D012189:Retrospective Studies; D012874:Skin Diseases, Infectious / Q000191:economics* / Q000601:surgery*; D040521:Subcutaneous Tissue; D055815:Young Adult