The economic impact of infections. An analysis of hospital costs and charges in surgical patients with cancer
D. J. Shulkin, B. Kinosian, H. Glick, C. Glen-Puschett, J. Daly and J. M. Eisenberg
Clinical Outcome and Quality Management, University of Pennsylvania Medical Center, Philadelphia, PA 19104-4274.
We performed an economic analysis of the care provided to patients
undergoing major abdominal surgical procedures to determine the effect of
postoperative infection on hospital resource use. Patients' clinical and
demographic characteristics and their use of medical care services were
determined from a review of hospital bills and medical records. Hospital
charges were obtained from the hospital billing system and costs were
determined by use of Medicare cost-charge ratios obtained from the
hospital's Medicare Cost Report. The care of patients with postoperative
infections was significantly more expensive than that of uninfected
patients (multivariate analysis indicated that a surgical infection added
$12,542 to the cost of patient care). Patients with postoperative fever but
without documented infection were also more expensive to care for than
afebrile, uninfected patients (fever added $9145 to the cost of care).
Increased costs for infected patients were found among microbiology tests,
radiology services, pharmaceutical costs, and room costs. For these
patients, we found that use of departmental cost-charge ratios, instead of
hospital-wide cost-charge ratios, had no substantial impact on comparison
of the cost of care for infected and uninfected patients.
