title: The economic significance of orthopaedic infections.
abstract: Musculoskeletal infections are a leading cause of patient morbidity and rising healthcare expenditures. The incidence of musculoskeletal infections, including soft-tissue infections, periprosthetic joint infection, and osteomyelitis, is increasing. Cases involving both drug-resistant bacterial strains and periprosthetic joint infection in total hip and total knee arthroplasty are particularly costly and represent a growing economic burden for the American healthcare system. With the institution of the Affordable Care Act, there has been an increasing drive in the United States toward rewarding healthcare organizations for their quality of care, bundling episodes of care, and capitating approaches to managing populations. In current reimbursement models, complications following the index event, including infection, are not typically reimbursed, placing the burden of caring for infections on the physician, hospital, or accountable care organization. Without the ability to risk-stratify patient outcomes based on patient comorbidities that are associated with a higher incidence of musculoskeletal infection, healthcare organizations are disincentivized to care for moderate- to high-risk patients. Reducing the cost of treating musculoskeletal infection also depends on incentivizing innovations in infection prevention.
authors: Daniel J
authors: DJ
authors: Hackett
authors: Adam C
authors: AC
authors: Rothenberg
authors: Antonia F
authors: AF
authors: Chen
authors: Christina
authors: C
authors: Gutowski
authors: David
authors: D
authors: Jaekel
authors: Ivan M
authors: IM
authors: Tomek
authors: Brian S
authors: BS
authors: Parsley
authors: Paul
authors: P
authors: Ducheyne
authors: Paul A
authors: PA
authors: Manner
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D001850:Bone Diseases, Infectious / Q000191:economics* / Q000453:epidemiology / Q000209:etiology; D024881:Drug Resistance, Bacterial; D017050:Episode of Care; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D058991:Patient Protection and Affordable Care Act; D016459:Prosthesis-Related Infections / Q000191:economics* / Q000453:epidemiology / Q000209:etiology; D012052:Reimbursement, Incentive; D014481:United States / Q000453:epidemiology