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Cost of organ/space infection in elective colorectal surgery. Is it just a problem of rates?
© Shaw et al; licensee BioMed Central Ltd. 2015
Published: 16 June 2015
Organ/space (O/S) infection in colorectal surgery remains a major health problem. In Catalonia, the VINCat Program has monitored 24,832 procedures during 2007-2014, showing a steady rate of O/S infection over the years, 8.2% (95% CI 7.9 - 8.6). Improving awareness of stakeholders could be an easy strategy for assembling quality programs within health systems.
Evaluating excess costs of organ/space infections associated with elective colorectal surgery in the Catalan Health System.
We selected a sample of 10 different sized hospitals that provided data to VINCat from January 2012-June 2014. To estimate the excess of cost we based on differences between lengths of stay in patients with and without O/S infection and extra-cost related to readmission/need of ICU and re-operation.
A total of 2276 patients underwent elective colorectal surgery. O/S infection occurred in 193 (8.5%). Patients with O/S were more frequently men (73% versus 60%; p = 0.001); underwent a rectal procedure (43% versus 31%; p<0.001) and had NNIS index ≥ 1 (43% versus 34%; p = 0.06). Median length of stay was 3 fold higher (22 days versus 7 days; p < 0.001) when O/S occurred which accounted for an extra cost of €3,052 per patient. Within the group of O/S infection, 45/193(23%) patients were re-admitted with a median length of stay of 13 days [IQR 8 - 17)]; 117/193 (60%) required re-operation and 56/193 (29%) required intensive care unit stay with a median length of stay of 5 days [IQR 3 - 12]. This added an additional cost of €2,235 per patient. Accordingly, 193 O/S infections accounted for an overall excess cost of €1,020,391.
O/S infection represents an important excess of cost for the Catalan Health System. The reinforcement of quality strategies can lead to a strong reduction in the use of resources and relieve its current financial constraints.
Disclosure of interest
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.