Major articleSurgical site infection: Incidence and impact on hospital utilization and treatment costs
Section snippets
Study data
The study is based on 2005 hospital stay data from the Nationwide Inpatient Sample (NIS), a component of the Agency for Healthcare Quality and Research (AHRQ) Healthcare Cost and Utilization Project (HCUP).3 HCUP is a federally sponsored nationally representative survey designed to approximate a 20% stratified sample of discharges from the nation's acute care community hospitals and comprises the largest available all-payer inpatient care database in the United States. The 2005 HCUP data
Rate of SSI
The 7 categories of surgical hospitalizations that we selected for analysis from the 2005 NIS database comprised a total of 723,490 hospitalizations (Table 1). Among this total number of cases, we identified 6891 cases of SSI for an overall rate of 9.5 cases per 1000 surgical hospitalizations or just under 1%. Projected to the national level, the 7 surgical categories accounted for an estimated 3,544,658 admissions with 33,846 cases involving SSI. Further detail on rates of SSI as observed in
Discussion
In the United States, administrative databases containing diagnosis and procedure codes are generated as a by-product of processing claims for reimbursement from third-party payers. These data are widely used for purposes other than payment, including health services research and quality of care assessment. Deficiencies in claims data when used in this manner have been widely described and include the fact that payment incentives can encourage providers to underreport or overreport particular
Conclusion
Measures to reduce rates of preventable SSI and their associated adverse outcomes will improve the safety and quality of care while avoiding substantial costs, thereby benefiting all consumers of health care. Change in Medicare payment policy eliminating additional payments for health care-associated infection underscores the urgent need for hospital leaders to address this important problem.
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Financial support for this study was provided by ETHICON, Inc.