Cost-effectiveness analysis of an active 30-day surgical site infection surveillance at a tertiary hospital in Ghana: evidence from HAI-Ghana study

ObjectiveTo assess the cost-effectiveness of an active 30-day surgical site infection (SSI) surveillance mechanism at a referral teaching hospital in Ghana using data from healthcare-associated infection Ghana (HAI-Ghana) study.DesignBefore and during intervention study using economic evaluation model to assess the cost-effectiveness of an active 30-day SSI surveillance at a teaching hospital. The intervention involves daily inspection of surgical wound area for 30-day postsurgery with quarterly feedback provided to surgeons. Discharged patients were followed up by phone call on postoperative days 3, 15 and 30 using a recommended surgical wound healing postdischarge questionnaire.SettingKorle-Bu Teaching Hospital (KBTH), Ghana.ParticipantsAll prospective patients who underwent surgical procedures at the general surgical unit of the KBTH.Main outcome measuresThe primary outcome measures were the avoidable SSI morbidity risk and the associated costs from patient and provider perspectives. We also reported three indicators of SSI severity, that is, length of hospital stay (LOS), number of outpatient visits and laboratory tests. The analysis was performed in STATA V.14 and Microsoft Excel.ResultsBefore-intervention SSI risk was 13.9% (62/446) as opposed to during-intervention 8.4% (49/582), equivalent to a risk difference of 5.5% (95% CI 5.3 to 5.9). SSI mortality risk decreased by 33.3% during the intervention while SSI-attributable LOS decreased by 32.6%. Furthermore, the mean SSI-attributable patient direct and indirect medical cost declined by 12.1% during intervention while the hospital costs reduced by 19.1%. The intervention led to an estimated incremental cost-effectiveness ratio of US$4196 savings per SSI episode avoided. At a national scale, this could be equivalent to a US$60 162 248 cost advantage annually.ConclusionThe intervention is a simple, cost-effective, sustainable and adaptable strategy that may interest policymakers and health institutions interested in reducing SSI.

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The Cost-Effectiveness of Wound-Edge Protection Devices Compared to Standard Care in Reducing Surgical Site Infection after Laparotomy: An Economic Evaluation alongside the ROSSINI Trial

PLoS ONE ◽

10.1371/journal.pone.0095595 ◽

2014 ◽

Vol 9 (4) ◽

pp. e95595 ◽

Cited By ~ 15

Author(s):

Adrian Gheorghe ◽

Tracy E. Roberts ◽

Thomas D. Pinkney ◽

David C. Bartlett ◽

Dion Morton ◽

...

Keyword(s):

Economic Evaluation ◽

Cost Effectiveness ◽

Surgical Site Infection ◽

Standard Care ◽

Site Infection ◽

Wound Edge ◽

Protection Devices ◽

The Cost

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Systematic review of the cost-effectiveness of preoperative antibiotic prophylaxis in reducing surgical-site infection

BJS Open ◽

10.1002/bjs5.45 ◽

2018 ◽

Vol 2 (3) ◽

pp. 81-98 ◽

Cited By ~ 11

Author(s):

J. Allen ◽

M. David ◽

J. L. Veerman

Keyword(s):

Systematic Review ◽

Cost Effectiveness ◽

Surgical Site Infection ◽

Antibiotic Prophylaxis ◽

Site Infection ◽

Preoperative Antibiotic Prophylaxis ◽

The Cost

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Cost-Effectiveness of Preoperative Nasal Mupirocin Treatment in Preventing Surgical Site Infection in Patients Undergoing Total Hip and Knee Arthroplasty: A Cost-Effectiveness Analysis

Infection Control and Hospital Epidemiology ◽

10.1086/663704 ◽

2012 ◽

Vol 33 (2) ◽

pp. 152-159 ◽

Cited By ~ 72

Author(s):

Xan F. Courville ◽

Ivan M. Tomek ◽

Kathryn B. Kirkland ◽

Marian Birhle ◽

Stephen R. Kantor ◽

...

Keyword(s):

Cost Effectiveness ◽

Decision Tree ◽

Surgical Site Infection ◽

Hypothetical Cohort ◽

Preoperative Treatment ◽

Site Infection ◽

Tree Model ◽

Effectiveness Analysis ◽

Nasal Mupirocin ◽

The Cost

Objective.To perform a cost-effectiveness analysis to evaluate preoperative use of mupirocin in patients with total joint arthroplasty (TJA).Design.Simple decision tree model.Setting.Outpatient TJA clinical setting.Participants.Hypothetical cohort of patients with TJA.Interventions.A simple decision tree model compared 3 strategies in a hypothetical cohort of patients with TJA: (1) obtaining preoperative screening cultures for all patients, followed by administration of mupirocin to patients with cultures positive for Staphylococcus aureus; (2) providing empirical preoperative treatment with mupirocin for all patients without screening; and (3) providing no preoperative treatment or screening. We assessed the costs and benefits over a 1-year period. Data inputs were obtained from a literature review and from our institution's internal data. Utilities were measured in quality-adjusted life-years, and costs were measured in 2005 US dollars.Main Outcome Measure.Incremental cost-effectiveness ratio.Results.The treat-all and screen-and-treat strategies both had lower costs and greater benefits, compared with the no-treatment strategy. Sensitivity analysis revealed that this result is stable even if the cost of mupirocin was over $100 and the cost of SSI ranged between $26,000 and $250,000. Treating all patients remains the best strategy when the prevalence of S. aureus carriers and surgical site infection is varied across plausible values as well as when the prevalence of mupirocin-resistant strains is high.Conclusions.Empirical treatment with mupirocin ointment or use of a screen-and-treat strategy before TJA is performed is a simple, safe, and cost-effective intervention that can reduce the risk of SSI. S. aureus decolonization with nasal mupirocin for patients undergoing TJA should be considered.Level of Evidence.Level II, economic and decision analysis.Infect Control Hosp Epidemiol 2012;33(2):152-159

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EFFICACY OF ANTIBIOTICS PROPHYLAXIS IN PATIENTS WITH LUMBAR DISC HERNIATION UNDERGOING LUMBAR DISCETOMY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.5.2 ◽

2018 ◽

Vol 8 (5) ◽

pp. 14-19

Author(s):

Tri Truong Van ◽

Tri Tran Duc Duy ◽

Khai Vo Le Quang

Keyword(s):

Surgical Site Infection ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Lumbar Discectomy ◽

University Hospital ◽

Site Infection ◽

Surgical Wound ◽

A Prospective Study ◽

Length Of Hospitalization

Introduction: Surgical wound infection in developing coutries is about 3%. Antibiotics prophylaxis may help to reduce the surgical site infection. The objective of this study was to evaluate the efficacy of antibiotics prophylaxis in patients with lumbar disc herniation who were treated with lumbar discectomy at Hue University hospital. Materials and Methods: A prospective study was conducted at Hue University hospital from March 2015 to May 2018 on 54 patients with lumbar disc herniation who were used antibiotics prophylaxis when undergoing discectomy. Results: The infection rate in our study was 0%. Antibiotics prophylaxis reduced the length of hospitalization as well as the medical cost. Conclusion: Antibiotics prophylaxis was effective in preventing surgical site infection despite the fact that the condition of operating rooms did not meet the standard rules. Key words: prophylaxis antibiotics, lumbar disc herniation

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Incidence of surgical site infection in dogs undergoing soft tissue surgery: risk factors and economic impact

Veterinary Record Open ◽

10.1136/vetreco-2017-000233 ◽

2019 ◽

Vol 6 (1) ◽

pp. e000233

Author(s):

Jorge Espinel-Rupérez ◽

Maria Dolores Martín-Ríos ◽

Veronica Salazar ◽

Maria Rosario Baquero-Artigao ◽

Gustavo Ortiz-Díez

Keyword(s):

Risk Factors ◽

Soft Tissue ◽

Surgical Site Infection ◽

Economic Impact ◽

Teaching Hospital ◽

Primary Outcome Measure ◽

Site Infection ◽

Urinary Catheterisation ◽

Organ Space Infection ◽

Soft Tissue Surgery

ObjectivesTo determine (1) the incidence of surgical site infection (SSI) in patients undergoing soft tissue surgery at a veterinary teaching hospital and to study (2) and describe the main risk factors associated with SSI and (3) assess the economic impact of SSI.DesignProspective cohort study.SettingVeterinary teaching hospital.Participants184 dogs undergoing soft tissue surgery during a 12-month period (October 2013 to September 2014).Primary outcome measureSurgical site infection.ResultsOut of the 184 patients analysed, SSI was diagnosed in 16 (8.7 per cent) patients, 13 (81.3 per cent) were classified as superficial incisional infection, 2 (12.5 per cent) as deep incisional infection and 1 (6.3 per cent) as organ/space infection. The administration of steroidal anti-inflammatory drugs (P=0.028), preoperative hyperglycaemia (P=0.015), surgical times longer than 60 minutes (P=0.013), urinary catheterisation (P=0.037) and wrong use of the Elizabethan collar (P=0.025) were identified as risk factors. Total costs increased 74.4 per cent, with an increase in postsurgical costs of 142.2 per cent.ConclusionsThe incidence of SSI was higher than the incidence reported in other published studies, although they were within expected ranges when a surveillance system was implemented. This incidence correlated with an increase in costs. Additionally new important risk factors for its development were detected.

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