Cost-effectiveness analysis of an active 30-day surgical site infection surveillance at a tertiary hospital in Ghana: evidence from HAI-Ghana study.
Cost-effectiveness analysis of an active 30-day surgical site infection surveillance at a tertiary hospital in Ghana: evidence from HAI-Ghana study.
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DOI：
10.1136/bmjopen-2021-057468
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发表时间：
2022-01-03
期刊：
影响因子：
2.9
通讯作者：
Enemark U
中科院分区：
文献类型：
--
作者：
Otieku E;Fenny AP;Asante FA;Bediako-Bowan A;Enemark U
使用加纳卫生保健相关感染（HAI-Ghana）研究的数据，评估加纳转诊教学医院主动30天手术部位感染（SSI）监测机制的成本效益。在干预研究之前和期间，使用经济评估模型评估教学医院主动30天SSI监测的成本效益。干预措施包括术后30天每天检查手术伤口区域，每季度向外科医生提供反馈。出院患者在术后第3、15和30天使用推荐的手术伤口愈合出院后问卷进行电话随访。Korle-Bu教学医院，加纳。所有在KBTH普外科接受手术的前瞻性患者。主要结局指标为可避免的SSI发病率风险和患者和提供者角度的相关成本。我们还报告了SSI严重程度的三个指标，即住院时间（LOS）、门诊就诊次数和实验室检查。在STATA V.14和Microsoft Excel中进行分析。干预前SSI风险为13.9%（62/446），而干预期间为8.4%（49/582），相当于5.5%的风险差异（95% CI 5.3 - 5.9）。干预期间SSI死亡风险降低了33.3%，而SSI归因的LOS降低了32.6%。此外，平均SSI归因于患者的直接和间接医疗费用下降了12.1%，而住院费用下降了19.1%。该干预措施导致每避免一次SSI事件估计可节省4196美元的增量成本效益比。在全国范围内，这相当于每年60 162 248美元的成本优势。干预措施是一种简单、具有成本效益、可持续和适应性强的战略，可能会引起对减少SSI感兴趣的决策者和卫生机构的兴趣。
To assess the cost-effectiveness of an active 30-day surgical site infection (SSI) surveillance mechanism at a referral teaching hospital in Ghana using data from healthcare-associated infection Ghana (HAI-Ghana) study. Before and during intervention study using economic evaluation model to assess the cost-effectiveness of an active 30-day SSI surveillance at a teaching hospital. The intervention involves daily inspection of surgical wound area for 30-day postsurgery with quarterly feedback provided to surgeons. Discharged patients were followed up by phone call on postoperative days 3, 15 and 30 using a recommended surgical wound healing postdischarge questionnaire. Korle-Bu Teaching Hospital (KBTH), Ghana. All prospective patients who underwent surgical procedures at the general surgical unit of the KBTH. The primary outcome measures were the avoidable SSI morbidity risk and the associated costs from patient and provider perspectives. We also reported three indicators of SSI severity, that is, length of hospital stay (LOS), number of outpatient visits and laboratory tests. The analysis was performed in STATA V.14 and Microsoft Excel. Before-intervention SSI risk was 13.9% (62/446) as opposed to during-intervention 8.4% (49/582), equivalent to a risk difference of 5.5% (95% CI 5.3 to 5.9). SSI mortality risk decreased by 33.3% during the intervention while SSI-attributable LOS decreased by 32.6%. Furthermore, the mean SSI-attributable patient direct and indirect medical cost declined by 12.1% during intervention while the hospital costs reduced by 19.1%. The intervention led to an estimated incremental cost-effectiveness ratio of US$4196 savings per SSI episode avoided. At a national scale, this could be equivalent to a US$60 162 248 cost advantage annually. The intervention is a simple, cost-effective, sustainable and adaptable strategy that may interest policymakers and health institutions interested in reducing SSI.
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影响因子：
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