Boyce J M, Potter-Bynoe G, Dziobek L
Division of Infectious Diseases, Miriam Hospital, Providence, Rhode Island 02906.
Infect Control Hosp Epidemiol. 1990 Feb;11(2):89-93. doi: 10.1086/646127.
Of the more than 200,000 patients who undergo open heart surgery annually in the United States, 2% to 10% will develop a post-operative infection related to their surgery. The economic impact of such infections on hospitals under the prospective payment system is unclear. To study the effect of such infections on hospital costs and reimbursement patterns, we compared case patients with controls of similar age, sex, urgency of surgery and type of surgery. The postoperative stay for cases was significantly longer than for matched controls (26.8 days and 8.3 days, respectively; p = .0002). The mean hospital cost for case admissions ($25,957) was twice as high as for control admissions ($12,795) (p = .0002). Cases resulted in an average net loss to the hospital of $2,344 per patient, while controls yielded an average net gain of $3,196 per patient (p = .02). We conclude that hospitals have substantial financial incentives to minimize the incidence of postoperative wound infections associated with open heart surgery.
在美国，每年接受心脏直视手术的患者超过20万，其中2%至10%会发生与手术相关的术后感染。在预期支付系统下，此类感染对医院的经济影响尚不清楚。为了研究此类感染对医院成本和报销模式的影响，我们将病例患者与年龄、性别、手术紧迫性和手术类型相似的对照组进行了比较。病例组的术后住院时间明显长于匹配的对照组（分别为26.8天和8.3天；p = .0002）。病例组入院的平均医院成本（25,957美元）是对照组入院成本（12,795美元）的两倍（p = .0002）。病例组导致医院每名患者平均净亏损2,344美元，而对照组每名患者平均净收益3,196美元（p = .02）。我们得出结论，医院有很大的经济动机来尽量减少与心脏直视手术相关的术后伤口感染的发生率。
