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Total and Attributable Costs of Surgical-Wound Infections at a Canadian Tertiary-Care Center

Published online by Cambridge University Press:  02 January 2015

Dick Zoutman ,
Shirley McDonald  and
Dilini Vethanayagan
Dick Zoutman*
Affiliation:
Infection Control Service, Department of Pathology, Kingston General Hospital and Queen's University, Kingston, Ontario, Canada
Shirley McDonald
Affiliation:
Infection Control Service, Department of Pathology, Kingston General Hospital and Queen's University, Kingston, Ontario, Canada
Dilini Vethanayagan
Affiliation:
Infection Control Service, Department of Pathology, Kingston General Hospital and Queen's University, Kingston, Ontario, Canada
*
Infection Control Service, Kingston General Hospital, 76 Stuart SSt, Kingston, Ontario K7L 2V7, Canada; zoutfnan@cliff.path.queensu.ca.
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Abstract

OBJECTIVE: To determine the total and attributable costs of surgical-wound infections in a Canadian teaching hospital.

DESIGN: Retrospective incidence series study with chart review and examination of resource utilization attributable to wound infection. The charts of inpatients with wound infections were examined using the Appropriateness Evaluation Protocol (AEP), a validated chart review instrument designed to determine appropriateness of care, modified for wound infections.

SETTING: A university referral center in Canada.

PATIENTS: Medical records were abstracted from patients with wound infections who underwent an inpatient clean or clean-contaminated procedure during 1991.

MEASUREMENTS: During the wound-infection treatment period, the hospital costs associated with providing care were tabulated for all inpatient days and for outpatient and emergency visits. Costs taken into account included nursing salary and benefits, nonphysician professional services, operating room time, laboratory, pharmacy, supplies, ancillary tests, and hotel costs.

RESULTS: We identified 108 wound infections. Twenty-two patients required 28 surgical procedures related to a wound infection. Inpatient days totalled 1,116, costing $394,337. Fifty-five emergency and 42 clinic visits occurred, costing $27,193. By applying the AEP to the inpatient days, 833 days, or 10.2 days per case, were directly attributable to the wound infection. The hospital costs for inpatient care attributable to wound infections were $321,533 in total, or $3,937 per infection. Costs were distributed as follows: nursing, 51%; hotel, 14%; pharmacy, 10%; laboratory, 9%; emergency and outpatient clinic, 6%; professional services, 5%; operating room, 3%; and ancillary tests, 2%.

CONCLUSIONS: Wound infections contribute markedly to extra days of hospitalization and related costs. The AEP method is applied easily to determine attributable days of care and costs of wound infections, which are necessary to calculate the cost-benefit of infection control programs.

Type
Research Article
Information
Infection Control & Hospital Epidemiology , Volume 19 , Issue 4 , April 1998 , pp. 254 - 259
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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