The costs of surgical site infection after abdominal surgery in middle-income countries: Key resource use In Wound Infection (KIWI) study

Surgical site infection (SSI) is the most common complication of abdominal surgery, with substantial costs to patients and health systems. Heterogeneity in costing methods in existing SSI studies makes multi-country comparison challenging. The objective of the study was to assess the costs of SSI ac...

Full description

Saved in:

Bibliographic Details
Published in:	The Journal of hospital infection Vol. 136; pp. 38 - 44
Main Authors:	Jowett, S., Bhangu, A., Morton, D.G., Ghosh, D., Adagrah, L.A., Alhaji Alhassan, B.B., Amoako-Boateng, M.P., Appiah, A.B., Koggoh, P., Opandoh, I.N.M., Manu Maison Patrick Opoku Manu, M.A., Morna, M.T., Quartson, E.M., Koomson, B., Fosu, G., Serbeh, G., Acheampong, D.O., Acquaye, J., Adinku, M., Appiah, J., Arthur, J., Boakye-Yiadom, J., Boateng, E.A., Dally, C., Gyasi-Sarpong, C.K., Kwarley, N., Lovi, A.K., Nimako, B., Nyadu, B.B., Opoku, D., Osabutey, A., Tuffour, S., Yorke, J., Addo, K.G., Akosa, E.A., Kontor, B.E., Kyeremeh, C., Mensah, E., Toffah, G.K., Adu-Brobbey, R., Labaran, A.H., Owusu, A., Bennin, A., Kantanka, R.S., Kobby, E., Owusu, P.Y., Sie-Broni, C.A., Zume, M., Abdulai, D.R., Ayingayure, E., Osman, I., Kunfah, S., Musah, Y., Ofori, B., Owusu, E.A., Saba, A.H., Seidu, A.S., Tabiri, S., Ta-ang Yenli, E.M., Dhiman, J., Dhir, K., Hans, M., Haque, P., Mark Jesudason, E.D., K, P., Madankumar, L., Nagomy, I., Prasad, S., Kurien, E., Mathew, A., Prakash, D., Susan, A., Ortiz, R.C., Gonzalez, G.H., Miguelena, L.H., Romero, M.H., Aguirre, C.C., Mejia, H.O., Gomez del Campo, L.U., Sánchez, I.D., Vazquez, D.G., Lara, M.M., Sainz de la Fuente, A.N., Adeleye, V., Atoyebi, O., Belie, O., Ekwesianya, A., Ezenwankwo, F., Fatuga, A., Mokwenyei, O., Ogein, O., Oladimeji, A., Seyi-Olajide, J., Soibi-Harry, A., Ugwu, A., Williams, E., Agodirin, S., Lawal, S., Lawal, A., Shittu, A.
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-06-2023
Subjects:	Cesarean Section - adverse effects Data Collection Developing Countries Female Global South Healthcare costs Hospital acquired infections Humans Patient Outcomes Postoperative complication Pregnancy Risk Factors Surgical Wound Infection - epidemiology Surgical Wound Infection - etiology Surgical Wound Infection - prevention & control Wound infection Wound infection Patient Outcomes Healthcare costs Postoperative complication Global South Hospital acquired infections
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Surgical site infection (SSI) is the most common complication of abdominal surgery, with substantial costs to patients and health systems. Heterogeneity in costing methods in existing SSI studies makes multi-country comparison challenging. The objective of the study was to assess the costs of SSI across middle-income countries. Centres from a randomized controlled trial assessing interventions to reduce SSI (FALCON, ClinicalTrials.gov, NCT03700749NCT) were sampled from two upper-middle- (India, Mexico) and two lower-middle- (Ghana, Nigeria) income countries. The Key resource use In Wound Infection (KIWI) study collected data on postoperative resource use and costs from consecutive patients undergoing abdominal surgery with an incision >5 cm (including caesarean section) that were recruited to FALCON between April and October 2020. The overall costs faced by patients with and without SSI were compared by operative field contamination (clean-contaminated vs contaminated-dirty), country and timing (inpatient vs outpatient). A total of 335 patients were included in KIWI; SSI occurred in 7% of clean-contaminated cases and 27% of contaminated-dirty cases. Overall, SSI was associated with an increase in postoperative healthcare costs by 75.3% (€412 international Euros) after clean-contaminated surgery and 66.6% (€331) after contaminated-dirty surgery. The highest and lowest cost increases were in India for clean-contaminated cases (€517) and contaminated-dirty cases (€223), respectively. Overall, inpatient costs accounted for 96.4% of the total healthcare costs after clean-contaminated surgery and 92.5% after contaminated-dirty surgery. SSI was associated with substantial additional postoperative costs across a range of settings. Investment in health technologies to reduce SSI may mitigate the financial burden to patients and low-resource health systems.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	0195-6701 1532-2939
DOI:	10.1016/j.jhin.2023.03.023