Exploring the real costs of healthcare-associated infections: an international review

ABSTRACT

Purpose: Healthcare-associated infections acquired a high degree of dissemination, being considered a serious public health problem and assumed as one of the most common adverse events associated with healthcare. They have a significant impact on health systems by increasing hospital expenses, and compromising the healthcare quality and effectiveness. Surgical site infections (SSI) are considered one of the most serious complications that can occur after an orthopaedic surgery. The aim of this study is to contribute to the development of a framework to analyse the costs of infections related to hip and knee arthroplasties.

Methods: A literature review was conducted on databases, and articles published between January 2005 and April 2016 were searched.

Findings: A total of 14 articles met the inclusion criteria. Costs were grouped in hospitalization and treatment dimensions. For hospitalization, the indicators were the length of stay (LOS) and/or monetary costs; For treatment, the indicators were number of surgeries and LOS, or monetary costs. We observed that LOS is the most commonly used to estimate SSI direct costs. Patients who developed hip or knee arthroplasty infections remained in hospital 2.5–3 times longer and incurred hospital costs almost three times higher, when compared with an uninfected patient.

KEYWORDS:

• Hip and knee arthroplasties
• healthcare-associated infections (HAI)
• surgical site infections (SSI)
• length of stay
• costs

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

João Moura graduated from the School of Industrial Studies and Management at Polytechnic of Porto with a degree in Biomedical Engineering and an MSc from the Polytechnic of Porto in Organizational Management, expertise in Healthcare Units Management. This work was developed within the scope of the master's thesis named ‘Study of the direct costs of the healthcare associated infections from the primary hip and knee arthroplasties performed at the Hospital Center of S. João, EPE’.

Pilar Baylina graduated from the Faculty of Engineering at University of Porto with a degree in Chemical Engineering and an MSc in Environmental Engineering, and a PhD in Public Health from National School of Public Health – New University of Lisbon, expertise in Policy, Management, and Administration in Health (Quality Management in Healthcare and Healthcare-Associated Infections). She is an Assistant Professor at the School of Health – Polytechnic of Porto since 2003. She is working in the Health sector since 1998, with the focus in Quality and Environmental Management and has 8 years of experience as auditor and consultant for the development and implementation of Quality management systems. She also collaborated with Portuguese Certification agencies as an external auditor and trainer (national and international) in the field of Patient Safety and Quality in Health. Actually, she is working on some projects related to the impact of healthcare-associated infections in public health management, more specifically in orthopedic hospital departments.

Joaquim Paulo Moreira, PhD in Health Management (UK, MBS), holds 18 years of experience in health management including hospital management and health quality accreditation auditing.

ORCID

Pilar Baylina http://orcid.org/0000-0002-3740-862X

Paulo Moreira http://orcid.org/0000-0002-3644-1022