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Dispatch
Costs of Surgical Site Infections
That Appear after Hospital Discharge
Nicholas Graves,*†
Kate Halton,*† Merrilyn Curtis,* Shane Doidge,* David Lairson,‡ Marylou
McLaws,§ and Michael Whitby*
*The Centre for Healthcare Related Infection Surveillance and Prevention,
Brisbane, Queensland, Australia; †Queensland University of Technology,
Brisbane, Queensland, Australia; ‡University of Texas Health Science Center
at Houston, Houston, Texas, USA; and §University of New South Wales, Sydney,
New South Wales, Australia
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Appendix 1. Effect of surgical site infection
(SSI) on cost outcomes controlling for multiple confounding factors,*
the results of OLS regression estimated with robust standard errors†‡ |
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Outcomes |
Coeff. on SSI (robust st err) |
95% CI lower:upper |
t |
p >|t| |
R2 |
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Costs incurred by healthcare services |
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No. of contacts with hospital-based services in
4 wk PD |
0.44 (0.26) |
–0.07:0.95 |
1.71 |
0.088 |
0.1996 |
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Cost of contacts with hospital-based services in
4 wk PD ($) |
15.73 (9.46) |
–2.88:34.34 |
1.66 |
0.097 |
0.1971 |
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No. of contacts with community-based services in
4 wk PD |
1.36 (0.63)† |
0.13:2.59 |
2.17 |
0.031 |
0.185 |
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Cost of contacts with community-based services in
4 wk PD ($) |
47.78 (23.07)† |
2.38:93.18 |
2.07 |
0.039 |
0.1809 |
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No. of tests/swabs |
–-0.06 (0.35) |
–0.75:0.62 |
-0.19 |
0.853 |
0.1656 |
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Costs of tests/swabs ($) |
–3.52 (8.09) |
–19.45:12.41 |
-0.43 |
0.664 |
0.1668 |
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No. of days receiving antimicrobial drugs during
4 wk PD |
6.46 (1.50)† |
3.51:9.41 |
4.31 |
>0.001 |
0.1668 |
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Costs of antimicrobial drugs |
14.44 (3.76)† |
7.04:21.84 |
3.84 |
>0.001 |
0.2994 |
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Sum of all costs incurred by healthcare services,
excluding costs of readmission ($) |
74.48 (29.48)† |
16.48:132.49 |
2.53 |
0.012 |
0.2056 |
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Sum of all costs incurred by healthcare services,
including costs of readmission ($) |
123.44 (53.50) |
18.17:228.71 |
2.31 |
0.022 |
0.1985 |
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Production losses |
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Patient production losses during 4 wk PD (min) |
699.83 (1,069.22) |
–1,404.18:2,803.84 |
0.65 |
0.513 |
0.3935 |
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Monetary valuation of patient production losses
($) |
253.26 (386.93) |
–508.15:1,014.67 |
0.65 |
0.513 |
0.3935 |
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Informal care givers' production losses during 4
wk PD (min) |
946.42 (579.55) |
–193.99:2,086.83 |
1.63 |
0.103 |
0.2787 |
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Monetary valuation of informal care giver production
losses ($) |
342.53 (209.74) |
–70.19:755.26 |
1.63 |
0.103 |
0.2787 |
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Private costs incurred by patients |
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Time patient spent accessing hospital services (min) |
68.57 (74.28) |
–77.60:214.73 |
0.92 |
0.357 |
0.1056 |
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Time patient spent accessing community-based services
(min) |
180.21 (95.38) |
–7.46:367.89 |
1.89 |
0.06 |
0.1234 |
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Total of out-of-pocket expenditures during 4 wk
PD ($) |
–3.01 (3.06) |
–9.03:3.02 |
–0.98 |
0.327 |
0.1672 |
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Difference in SF-12 Mental Component Summary (enrollment
vs wk 4) |
–0.59 (2.32) |
–5.16:3.98 |
–0.26 |
0.799 |
0.1653 |
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Difference in SF-12 Physical Component Summary (enrollment
vs wk 4) |
0.49 (2.69) |
–4.81:5.79 |
0.18 |
0.855 |
0.1769 |
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*The coefficient (coeff.) on SSI was estimated after
controlling for sex, age, recruiting hospital, length of hospital
stay, socioeconomic status, whether patient was in waged employment,
salary level, type of surgery (International Classification of Diseases,
10th ed. system), education level, ASA, American Association of
Anaesthetists, wound class, duration of surgery, number of coexisting
conditions, ethnicity, whether patient was private or public, SF-12,
scores at baseline and week 4 postdischarge (PD) (except for the
models in which the difference in SF-12 scores is the outcome. |
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†Statistically significant at the 5% level. |
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‡OLS, ordinary least squares; robust st err, robust
standard error; CI, confidence interval; R2, relative
predictive power of model; SF-12, SF-12v2 Health Survey; min, minutes
of time. |
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