Click here to download

Definizione di un modello di analisi degli extra-costi legati alle infezioni del sito chirurgico (ISC): uno studio in ambito ortopedico e traumatologico Azienda Ospedaliera Istituto Ortopedico "Gaetano Pini"
Journal Title: MECOSAN 
Author/s: Marta Nobile, Paola Navone, Giorgio Maria Calori, Alessandra Orzella, Letizia DiChiara, Romina Colciago, Francesco Auxilia 
Year:  2016 Issue: 97 Language: Italian 
Pages:  10 Pg. 91-100 FullText PDF:  23521 KB
DOI:  10.3280/MESA2016-097006
(DOI is like a bar code for intellectual property: to have more infomation:  clicca qui   and here 

This project aims to develop a model for assessing the direct cost of SSIs borne by the hospital and the regional health service. The study was run by the Gaetano Pini Orthopaedic Institute in partnership with Aon Hewitt Risk & Consulting AGRC Italy and the University of Milan. Seven patients who developed an SSI during the ISChIA active prospective surveillance project were chosen for the study. A model for analysing the additional costs of an SSI was developed considering two different scenarios: hospital admission with diagnosis related groups (DRG) up coding attributable to the SSI and cases where the extra costs could be traced back to subsequent hospital admissions or outpatient procedures. Moreover, an analysis aimed at establishing the costs borne by the hospital and those borne by the regional health service was carried out.
Keywords: Surgical site infection, orthopedic, joint replacement, surveillance, extra costs, analysis’ model

  1. Birrell F., Johnell O., Silman A. (1999). Projecting the need for hip replacement over the next three decades: influence of changing demography and threshold for surgery. Annals of the Rheumatic Diseases, 58 (9): 569-572., DOI: 10.1136/ard.58.9.569
  2. Bozic K.J., Ries, M.D. (2005). The impact of infection after total hip arthroplasty on hospital and surgeon resource utilization. The Journal of Bone & Joint Surgery, 87 (8): 1746-51., DOI: 10.2106/JBJS.D.02937
  3. Broex E., Van Asselt A., Bruggeman C.A., Van Tiel
  4. F.H. (2009). Surgical site infections: how high are the costs?. The Journal of Hospital Infection, 72 (3): 193-201., DOI: 10.1016/j.jhin.2009.03.020
  5. Canadian Institute for Health Information (2009). Hip and Knee Replacements in Canada. Canadian Joint Replacement Registry (CJRR) 2008-2009 Annual Report.
  6. De Lissovoy G., Fraeman K., Hutchins V. et al. (2009). Surgical Site Infection: Incidence and Impact on Hospital Utilization and Treatment Costs. American Journal of Infection Control, 37 (5): 387-97., DOI: 10.1016/j.ajic.2008.12.010
  7. ECDC (2008). Focus on healthcare-associated infections, Annual epidemiological report.
  8. Eupolis Lombardia (2012). Analisi dei costi diretti e indiretti delle infezioni nosocomiali in pazienti ospedalizzati e individuazione di linee di intervento
  9. per la prevenzione e la protezione, Rapporto finale. Horan T.C., Andrus M., Dudeck M.A. CDC/NHSN (2008). Surveillance definition of Health-Care associated infection and criteria for specific types of infections in the acute care settings. American Journal of Infect Control, 36 (5): 309-32., DOI: 10.1016/j.ajic.2008.03.002
  10. Kapadia B.H., McElroy M.J., Issa K., et al. (2014). The economic impact of Periprosthetic Infections Following Total Knee Arthroplasty at a Specialized Tertiary-Care Center. The Journal of Arthroplasty, 29 (5): 929-932., DOI: 10.1016/j.arth.2013.09.017
  11. Kurtz S.M., Lau E., Watson H., Schmier J.K., Parvizi J. (2012). Economic Burden of Periprosthetic Joint Infection in the United States. The Journal of Arthroplasty, 27 (8): 61-65., DOI: 10.1016/j.arth.2012.02.022
  12. Liu S.S., Della Valle A.G., Besculides M.C., Gaber L.K., Memtsoudis S.G. (2008). Trends in mortality, complications, and demographics for primary hip arthroplasty in the United States. International orthopaedics, 33 (3): 643-51., DOI: 10.1007/s00264-008-0549-4
  13. Merollini K., Crawford R.W., Graves N. (2013).
  14. Surgical Treatment Approaches and Reimbursment costs of surgical site infections post hip arthroplasty in Australia: a retrospective analysis. BMC Health Services Research, 13 (1): 91., DOI: 10.1186/1472-6963-13-91
  15. Peel T.N., Dowsey M.M., Buising K.L., Liew D.,
  16. Choong P.F.M. (2011). Cost analysis of debridement and retention for management of prothesic joint infection. Clinical Microbiology and Infection, 19 (2): 181-186., DOI: 10.1111/j.1469-0691.2011.03758.x
  17. Perencevich E.N., Sands K.E., Cosgrove S.E. et al. (2003). Health and Economic Impact of Surgical Site Infections Diagnosed after Hospital Discharge. Emerging Infectious Diseases 9 (2): 196-203., DOI: 10.3201/eid0902.020232
  18. Poultsides L.A. et al. (2013). In-Hospital Surgical Site Infections after Primary Hip and Knee Arthroplasty. Incidence and Risk Factors. The Journal of Arthroplasty, 28 (3): 385-389., DOI: 10.1016/j.arth.2012.06.027
  19. Singh J.A. (2011). Epidemiology of Knee and Hip Arthroplasty: A Systematic Review. The Open Orthopaedics Journal, 5 (1): 80-85., DOI: 10.2174/1874325001105010080
  20. Whitehouse J.D., Friedman N.D., Kirkland K.B.,
  21. Richardson W.J., Sexton D.J. (2002). The impact of Surgical Site Infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay and extra cost. Infection control and hospital epidemiology, 23 (4):183-189., DOI: 10.1086/502033
  22. Zingg et al. (2015) Hospital organization, management and structure for prevention of health-careassociated infection: a systematic review and expert consensus. The Lancet Infectious Diseases, 15 (2): 212-24., DOI: 10.1016/s1473-3099(14)70854-0

Marta Nobile, Paola Navone, Giorgio Maria Calori, Alessandra Orzella, Letizia DiChiara, Romina Colciago, Francesco Auxilia, in "MECOSAN" 97/2016, pp. 91-100, DOI:10.3280/MESA2016-097006


FrancoAngeli is a member of Publishers International Linking Association a not for profit orgasnization wich runs the CrossRef service, enabing links to and from online scholarly content