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  • Open Access

Cost of organ/space infection in elective colorectal surgery. Is it just a problem of rates?

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Antimicrobial Resistance and Infection Control20154 (Suppl 1) :P77

https://doi.org/10.1186/2047-2994-4-S1-P77

  • Published:

Keywords

  • Intensive Care Unit
  • Intensive Care Unit Stay
  • Major Health
  • Median Length
  • Strong Reduction

Introduction

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.

Objectives

Evaluating excess costs of organ/space infections associated with elective colorectal surgery in the Catalan Health System.

Methods

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.

Results

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.

Conclusion

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

None declared.

Authors’ Affiliations

(1)
Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
(2)
Hospital Parc Taulí, Sabadell, Barcelona, Spain
(3)
Fundació Althaia de Manresa, Manresa, Barcelona, Spain
(4)
Fundació Hospital Asil de Granollers, Granollers, Barcelona, Spain
(5)
Hospital de Viladecans, Viladecans, Barcelona, Spain
(6)
Consorci Sanitari de l'Anoia, Igualada, Barcelona, Spain
(7)
Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
(8)
Consorci Sanitari de Terrassa, Terrassa, Barcelona, Spain
(9)
Hospital Universitari Sant Joan de Reus, Reus, Tarragona, Spain
(10)
Hospital General-Parc Sanitari Sant Joan de Déu, Saint Boi de Llobregat, Barcelona, Spain
(11)
VINCat Program, Departament de Salut, Hospitalet de Llobregat, Barcelona, Spain

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