Incidence and impact of surgical site complications on length of stay and cost of care for patients undergoing open procedures
Background: Surgical site complications (SSCs) can have serious and life-threatening consequences for patients; however, their frequency and impact on healthcare utilization across surgical procedures, particularly for non-infectious SSCs, are unknown. This study examined incidence of overall SSCs a...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | Surgery Open Science |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589845023000271 |
| _version_ | 1827908265279750144 |
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| author | Yuefeng Hou, PhD Ashley Collinsworth, ScD, MPH, Senior Research Scientist Flutura Hasa, MD, MPH, MHE Leah Griffin, MS |
| author_facet | Yuefeng Hou, PhD Ashley Collinsworth, ScD, MPH, Senior Research Scientist Flutura Hasa, MD, MPH, MHE Leah Griffin, MS |
| author_sort | Yuefeng Hou, PhD |
| collection | DOAJ |
| description | Background: Surgical site complications (SSCs) can have serious and life-threatening consequences for patients; however, their frequency and impact on healthcare utilization across surgical procedures, particularly for non-infectious SSCs, are unknown. This study examined incidence of overall SSCs and non-infectious SSCs in patients undergoing open surgical procedures in the United States and their effect on length of stay (LOS) and costs. Methods: This retrospective study utilizing 2019–2020 data from Medicare and Premier Health Database identified patients with SSCs during hospitalization or within 90 days of discharge. Propensity score matching was used to calculate incremental LOS and costs attributable to SSCs. Mean LOS and costs attributable to SSCs for the index admission, readmissions, and outpatient visits were summed by procedure and Charlson Comorbidity Index score to estimate the overall impact of an SSC on LOS and costs across healthcare settings. Results: Overall and non-infectious SSC rates were 7.3 % and 5.3 % respectively for 2,696,986 Medicare and 6.7 % and 5.0 % for 1,846,254 Premier open surgeries. Total incremental LOS and cost per SSC were 7.8 days and $15,339 for Medicare patients and 6.2 days and $17,196 for Premier patients. Incremental LOS and cost attributable to non-infectious SSCs were 6.5 days and $12,703 and 5.2 days and $14,477 for Medicare and Premier patients respectively. Conclusions: This study utilizing two large national databases provides strong evidence that SSCs, particularly non-infectious SSCs, are not uncommon in open surgeries and result in increased healthcare utilization and costs. These findings demonstrate the need for increased adoption of evidence-based interventions that can reduce SSC rates. |
| first_indexed | 2024-03-13T01:19:28Z |
| format | Article |
| id | doaj.art-6d65059d7cf346bb870c480f0ac880ea |
| institution | Directory Open Access Journal |
| issn | 2589-8450 |
| language | English |
| last_indexed | 2024-03-13T01:19:28Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery Open Science |
| spelling | doaj.art-6d65059d7cf346bb870c480f0ac880ea2023-07-05T05:16:55ZengElsevierSurgery Open Science2589-84502023-08-01143145Incidence and impact of surgical site complications on length of stay and cost of care for patients undergoing open proceduresYuefeng Hou, PhD0Ashley Collinsworth, ScD, MPH, Senior Research Scientist1Flutura Hasa, MD, MPH, MHE2Leah Griffin, MS33M, St Paul, MN, United States of AmericaCorresponding author at: 3M, Medical Solutions Division, 12930 W Interstate 10, San Antonio, TX 78249, United States of America.; 3M, St Paul, MN, United States of America3M, St Paul, MN, United States of America3M, St Paul, MN, United States of AmericaBackground: Surgical site complications (SSCs) can have serious and life-threatening consequences for patients; however, their frequency and impact on healthcare utilization across surgical procedures, particularly for non-infectious SSCs, are unknown. This study examined incidence of overall SSCs and non-infectious SSCs in patients undergoing open surgical procedures in the United States and their effect on length of stay (LOS) and costs. Methods: This retrospective study utilizing 2019–2020 data from Medicare and Premier Health Database identified patients with SSCs during hospitalization or within 90 days of discharge. Propensity score matching was used to calculate incremental LOS and costs attributable to SSCs. Mean LOS and costs attributable to SSCs for the index admission, readmissions, and outpatient visits were summed by procedure and Charlson Comorbidity Index score to estimate the overall impact of an SSC on LOS and costs across healthcare settings. Results: Overall and non-infectious SSC rates were 7.3 % and 5.3 % respectively for 2,696,986 Medicare and 6.7 % and 5.0 % for 1,846,254 Premier open surgeries. Total incremental LOS and cost per SSC were 7.8 days and $15,339 for Medicare patients and 6.2 days and $17,196 for Premier patients. Incremental LOS and cost attributable to non-infectious SSCs were 6.5 days and $12,703 and 5.2 days and $14,477 for Medicare and Premier patients respectively. Conclusions: This study utilizing two large national databases provides strong evidence that SSCs, particularly non-infectious SSCs, are not uncommon in open surgeries and result in increased healthcare utilization and costs. These findings demonstrate the need for increased adoption of evidence-based interventions that can reduce SSC rates.http://www.sciencedirect.com/science/article/pii/S2589845023000271 |
| spellingShingle | Yuefeng Hou, PhD Ashley Collinsworth, ScD, MPH, Senior Research Scientist Flutura Hasa, MD, MPH, MHE Leah Griffin, MS Incidence and impact of surgical site complications on length of stay and cost of care for patients undergoing open procedures Surgery Open Science |
| title | Incidence and impact of surgical site complications on length of stay and cost of care for patients undergoing open procedures |
| title_full | Incidence and impact of surgical site complications on length of stay and cost of care for patients undergoing open procedures |
| title_fullStr | Incidence and impact of surgical site complications on length of stay and cost of care for patients undergoing open procedures |
| title_full_unstemmed | Incidence and impact of surgical site complications on length of stay and cost of care for patients undergoing open procedures |
| title_short | Incidence and impact of surgical site complications on length of stay and cost of care for patients undergoing open procedures |
| title_sort | incidence and impact of surgical site complications on length of stay and cost of care for patients undergoing open procedures |
| url | http://www.sciencedirect.com/science/article/pii/S2589845023000271 |
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