Rehospitalisations Add Costs

The research team, led by Doctor Keith Kaye, analysed data from health insurance claims for approximately 40 million insured individuals covered by employer-based health plans. Their goal was to uncover the rate of readmission and the financial impact of surgical site infections (SSI) beyond the initial hospitalisation for that diagnosis.

The team chose to follow patients who had received artificial knees and hips because treatment for an infected joint can be prolonged, involving lengthy courses of antibiotics and additional surgeries.
Of the 174,425 patients in the database who underwent hip or knee replacement in 2007, 2,134 (1.2 per cent) were hospitalised for a surgical site infection (SSI) within one year following their procedure (in 2008). Of those, 267 (12.5 per cent) were subsequently re-hospitalised in the year after the initial SSI hospitalisation (in 2009) specifically due to SSI-related issues, for a total of 384 hospitalisations. The data also showed that 870 patients with SSI (40.8 per cent) were hospitalised for other reasons labeled "all cause" during the year after their diagnosis, accounting for 1,770 readmissions.

Subsequent rehospitalisations for SSI were associated with an average hospital stay of 8.6 days, costing on average 26,812 Dollars. Additional all-cause hospital readmissions were associated with an average hospital stay of 6.2 days and a cost of 31,046 Dollars.

According to the Centres for Disease Control and Prevention, infections develop in about 1 to 3 out of every 100 patients who have surgery.

"The prosthetic joint population was important to study because these patients are particularly vulnerable to adverse events following surgical site infections, leading to unnecessary pain, suffering and medical costs," said Kaye. "This analysis shows the devastation of these infections and probably underestimates the true extent of the problem. Given the government's focus on reducing readmission rates, such complications could likely be a future target for decreased reimbursement."; Source: Association for Professionals in Infection Control