Surgical Site Infections and their economic significance in hepatopancreatobiliary surgery: A retrospective incidence, cost, and reimbursement analysis in a German centre of the highest level of care
Surgical site infections (SSI) in open Hepatopancreatobiliary (HPB) surgery are common complications. They worsen patients’ outcomes and prolong hospital stays. Their economic significance in the German diagnosis related groups (DRG) system is mostly unknown. To investigate their economic importance...
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| Veröffentlicht in: | International wound journal 2021-02, Vol.18 (1), p.17-23 |
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| creator | Brennfleck, Frank Werner Bachmeier, Tanja Simet, Wolfgang Zeman, Florian Junger, Henrik Horst Gerhard Schlitt, Hans Jürgen Dahlke, Marc‐Hendrik Brunner, Stefan Martin |
| description | Surgical site infections (SSI) in open Hepatopancreatobiliary (HPB) surgery are common complications. They worsen patients’ outcomes and prolong hospital stays. Their economic significance in the German diagnosis related groups (DRG) system is mostly unknown. To investigate their economic importance, we evaluated all cases for SSIs as well as clinical and financial parameters undergoing surgery in our centre from 2015 and 2016. Subsequently, we carried out a cost‐revenue calculation by assessing our billing data and the cost matrix of the InEK (German Institute for the Payment System in Hospitals). A total of 13.5% of the patients developed a superficial, 9% a deep incisional, and 2.4% of the patients an organ space SSI. Compared with Patients without SSI, Patients with SSI had more comorbidities, were older, and their average length of stay was extended by 19 days (P |
| doi_str_mv | 10.1111/iwj.13511 |
| format | Article |
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They worsen patients’ outcomes and prolong hospital stays. Their economic significance in the German diagnosis related groups (DRG) system is mostly unknown. To investigate their economic importance, we evaluated all cases for SSIs as well as clinical and financial parameters undergoing surgery in our centre from 2015 and 2016. Subsequently, we carried out a cost‐revenue calculation by assessing our billing data and the cost matrix of the InEK (German Institute for the Payment System in Hospitals). A total of 13.5% of the patients developed a superficial, 9% a deep incisional, and 2.4% of the patients an organ space SSI. Compared with Patients without SSI, Patients with SSI had more comorbidities, were older, and their average length of stay was extended by 19 days (P < .001). The financial loss per SSI‐case was €‐7035.65 despite increased reimbursement, which resulted in a calculated total loss for the hospital of €‐802 064.62 in 2015 and 2016. Surgical site infections are common complications of open HPB surgery, which lead to a significant increase in the cost per case. Further prevention strategies need to be developed. Besides, an adjustment of revenues must be demanded.</description><identifier>ISSN: 1742-4801</identifier><identifier>EISSN: 1742-481X</identifier><identifier>DOI: 10.1111/iwj.13511</identifier><identifier>PMID: 33006236</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Analysis ; Anemia ; Bile ducts ; biliary tract surgical procedures (D001662) ; Body mass index ; Cardiovascular disease ; Costs ; costs and cost analysis (D003365) ; Diagnosis related groups ; Disease control ; Disease prevention ; Documentation ; DRGs ; Economic aspects ; Health aspects ; Hospitals ; Infection ; Kidney diseases ; length of stay (D007902) ; liver (D008099) ; Liver cirrhosis ; Nosocomial infections ; Original ; Patients ; Reimbursement ; Statistical analysis ; Surgery ; Surgical anastomosis ; Surgical site infections ; surgical wound infection (D013530) ; Thoracic surgery ; Transplants & implants ; Variables ; Variance analysis</subject><ispartof>International wound journal, 2021-02, Vol.18 (1), p.17-23</ispartof><rights>2020 The Authors. published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.</rights><rights>2020 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.</rights><rights>COPYRIGHT 2020 John Wiley & Sons, Inc.</rights><rights>2021. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the "License"). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5101-23f180ab81dc14a709b2c75ccadb852656e43576292b631800a46c32118660143</citedby><cites>FETCH-LOGICAL-c5101-23f180ab81dc14a709b2c75ccadb852656e43576292b631800a46c32118660143</cites><orcidid>0000-0001-8055-9282</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7948679/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7948679/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1417,11562,27924,27925,45574,45575,46052,46476,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33006236$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brennfleck, Frank Werner</creatorcontrib><creatorcontrib>Bachmeier, Tanja</creatorcontrib><creatorcontrib>Simet, Wolfgang</creatorcontrib><creatorcontrib>Zeman, Florian</creatorcontrib><creatorcontrib>Junger, Henrik Horst Gerhard</creatorcontrib><creatorcontrib>Schlitt, Hans Jürgen</creatorcontrib><creatorcontrib>Dahlke, Marc‐Hendrik</creatorcontrib><creatorcontrib>Brunner, Stefan Martin</creatorcontrib><title>Surgical Site Infections and their economic significance in hepatopancreatobiliary surgery: A retrospective incidence, cost, and reimbursement analysis in a German centre of the highest level of care</title><title>International wound journal</title><addtitle>Int Wound J</addtitle><description>Surgical site infections (SSI) in open Hepatopancreatobiliary (HPB) surgery are common complications. They worsen patients’ outcomes and prolong hospital stays. Their economic significance in the German diagnosis related groups (DRG) system is mostly unknown. To investigate their economic importance, we evaluated all cases for SSIs as well as clinical and financial parameters undergoing surgery in our centre from 2015 and 2016. Subsequently, we carried out a cost‐revenue calculation by assessing our billing data and the cost matrix of the InEK (German Institute for the Payment System in Hospitals). A total of 13.5% of the patients developed a superficial, 9% a deep incisional, and 2.4% of the patients an organ space SSI. Compared with Patients without SSI, Patients with SSI had more comorbidities, were older, and their average length of stay was extended by 19 days (P < .001). The financial loss per SSI‐case was €‐7035.65 despite increased reimbursement, which resulted in a calculated total loss for the hospital of €‐802 064.62 in 2015 and 2016. Surgical site infections are common complications of open HPB surgery, which lead to a significant increase in the cost per case. Further prevention strategies need to be developed. 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They worsen patients’ outcomes and prolong hospital stays. Their economic significance in the German diagnosis related groups (DRG) system is mostly unknown. To investigate their economic importance, we evaluated all cases for SSIs as well as clinical and financial parameters undergoing surgery in our centre from 2015 and 2016. Subsequently, we carried out a cost‐revenue calculation by assessing our billing data and the cost matrix of the InEK (German Institute for the Payment System in Hospitals). A total of 13.5% of the patients developed a superficial, 9% a deep incisional, and 2.4% of the patients an organ space SSI. Compared with Patients without SSI, Patients with SSI had more comorbidities, were older, and their average length of stay was extended by 19 days (P < .001). The financial loss per SSI‐case was €‐7035.65 despite increased reimbursement, which resulted in a calculated total loss for the hospital of €‐802 064.62 in 2015 and 2016. Surgical site infections are common complications of open HPB surgery, which lead to a significant increase in the cost per case. Further prevention strategies need to be developed. Besides, an adjustment of revenues must be demanded.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>33006236</pmid><doi>10.1111/iwj.13511</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-8055-9282</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis Anemia Bile ducts biliary tract surgical procedures (D001662) Body mass index Cardiovascular disease Costs costs and cost analysis (D003365) Diagnosis related groups Disease control Disease prevention Documentation DRGs Economic aspects Health aspects Hospitals Infection Kidney diseases length of stay (D007902) liver (D008099) Liver cirrhosis Nosocomial infections Original Patients Reimbursement Statistical analysis Surgery Surgical anastomosis Surgical site infections surgical wound infection (D013530) Thoracic surgery Transplants & implants Variables Variance analysis |
| title | Surgical Site Infections and their economic significance in hepatopancreatobiliary surgery: A retrospective incidence, cost, and reimbursement analysis in a German centre of the highest level of care |
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