Attributable Costs of Surgical Site Infection and Endometritis after Low Transverse Cesarean Delivery
Attributable Costs of Surgical Site Infection and Endometritis after Low Transverse Cesarean Delivery
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DOI：
10.1086/650755
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发表时间：
2010-03-01
影响因子：
4.5
通讯作者：
Fraser, Victoria J.
中科院分区：
文献类型：
--
作者：
Olsen, Margaret A.;Butler, Anne M.;Fraser, Victoria J.
背景医院获得性感染成本的准确数据是必要的，以确定其经济影响和潜在的预防策略的成本效益。通过两种不同的方法确定剖宫产术后手术部位感染（SSI）和尿道炎（EMM）的可归因成本。回溯队列设置。巴恩斯犹太医院，一家拥有1,250张床位的三级学术护理医院。1999年7月至2001年6月，共1,605例行低位横切口剖宫产术。SSI和EMM的归因成本通过广义最小二乘法（GLS）和倾向评分匹配对确定，通过管理索赔数据来定义潜在的合并症和程序。在配对分析中，未感染的对照组患者与SSI或EMM患者根据其发生感染的倾向进行配对，并计算费用的中位数差异。通过GLS计算的SSI的归因总医院成本为3，529美元，通过倾向评分配对计算的SSI的归因总医院成本为2，852美元。通过GLS计算的EMM的归因总医院成本为3，956美元，通过倾向评分匹配对为3，842美元。大部分超额费用与食宿和药房费用有关。SSI和EMM的成本低于更广泛的操作后报告的SSI成本。两种方法计算的EMM可归因成本非常接近，而倾向评分配对法计算的SSI成本低于GLS法计算的成本。进行医院获得性感染成本分析的研究者需要考虑这两种方法确定的成本差异。感染控制医院流行病学2010;31：276-282
BACKGROUND. Accurate data on costs attributable to hospital-acquired infections are needed to determine their economic impact and the cost-benefit of potential preventive strategies.OBJECTIVE. To determine the attributable costs of surgical site infection (SSI) and endometritis (EMM) after cesarean section by means of 2 different methods.DESIGN. Retrospective cohort.SETTING. Barnes-Jewish Hospital, a 1,250-bed academic tertiary care hospital.PATIENTS. There were 1,605 women who underwent low transverse cesarean section from July 1999 through June 2001.METHODS. Attributable costs of SSI and EMM were determined by generalized least squares (GLS) and propensity score matched-pairs by means of administrative claims data to define underlying comorbidities and procedures. For the matched-pairs analyses, uninfected control patients were matched to patients with SSI or with EMM on the basis of their propensity to develop infection, and the median difference in costs was calculated.RESULTS. The attributable total hospital cost of SSI calculated by GLS was $3,529 and by propensity score matched-pairs was $2,852. The attributable total hospital cost of EMM calculated by GLS was $3,956 and by propensity score matched-pairs was $3,842. The majority of excess costs were associated with room and board and pharmacy costs.CONCLUSIONS. The costs of SSI and EMM were lower than SSI costs reported after more extensive operations. The attributable costs of EMM calculated by the 2 methods were very similar, whereas the costs of SSI calculated by propensity score matched-pairs were lower than the costs calculated by GLS. The difference in costs determined by the 2 methods needs to be considered by investigators who are performing cost analyses of hospital-acquired infections. Infect Control Hosp Epidemiol 2010;31:276-282