SSI不仅会对患者的身体健康产生很大的影响,也会额外增加医院的医疗费用支出。以下为美国医院发生的SSI在这两方面所产生的影响。
在腹部手术当中,每20例患者中就有3例SSI高发生率的风险。
研究表明,在腹部手术当中,每20例患者中就有3例SSI高发生率的风险[1-3]。
de Lissovoy G[4]等人对患者的住院天数进行调查分析,结果发现SSI患者平均住院天数为15天,无SSI患者平均住院天数仅为8天。SSI患者再次入院率为27.8%,无SSI患者再次入院率仅为6.8%[5]。SSI患者ICU入住率为29%,无SSI患者ICU入住率仅为18%,相较于无SSI患者,SSI患者死亡风险增加了2倍[6]。
每年因SSI的花费为100亿美元 每例SSI患者额外费用19000美元 每个医院每年支付500万美元的罚款 医院负面影响
美国疾病预防控制中心报道,每年因为SSI支出的医疗费用100亿美元[7];根据2009年和2011年的数据分析,每例SSI患者因SSI额外的医疗费用支出为19000美元[5,8];每个医院由于SSI每年需要支付500万美元的罚款[9]。不仅仅是这些额外医疗费用的支出,SSI还会给医院带来较大的负面影响。
参考文献:
1 Watanabe A, Kohnoe S, Shimabukuro R, et al. Risk factors associated with surgical site infection in upper and lower gastrointestinal surgery. Surg Today. 2008;38(5):404-412.
2 Wick EC, Vogel JD, Church JM, Remzi F, Fazio VW. Surgical site infections in a "high outlier" institution: are colorectal surgeons to blame? Dis Colon Rectum. 2009;52(3):374-379.
3 Sutton E, Miyagaki H, Bellini G, et al. Risk factors for superficial surgical site infection after elective rectal cancer resection: a multivariate analysis of 8880 patients from the American College of Surgeons National Surgical Quality Improvement Program database. J Surg Res. 2017;207:205-214.
4 de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control. 2009;37(5):387-397.
5 Wick EC, Hirose K, Shore AD, et al. Surgical site infections and cost in obese patients undergoing colorectal surgery. Arch Surg. 2011;146(9):1068-1072.
6 Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE, Sexton DJ. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol. 1999;20(11):725-730.
7 Scott RD. The Direct Medical Costs of Healthcare-Associated Infection in US Hospitals and the Benefits of Prevention. Centers for Disease Control and Prevention; March 2009.
8 Tanner J, Khan D, Aplin C, Ball J, Thomas M, Bankart J. Post-discharge surveillance to identify colorectal surgical site infection rates and related costs. J Hosp Infect. 2009;72(3):243-250.
9 Rau J. Latest Hospital Injury Penalties Include Crackdown On Antibiotic-Resistant Germs. 2016; https://khn.org/news/latest-hospital-injury-penalties-include-crackdown-on-antibiotic-resistant-germs/._Accessed January 29, 2018.