Exploring the real costs of healthcare-associated infections: an international review

Abstract

Purpose: Healthcare-associated infections acquired a high degree of dissemination, being considered a serious public health problem and assumed as one of the most common adverse events associated with healthcare. They have a significant impact on health systems by increasing hospital expenses, and compromising the healthcare quality and effectiveness. Surgical site infections (SSI) are considered one of the most serious complications that can occur after an orthopaedic surgery. The aim of this study is to contribute to the development of a framework to analyse the costs of infections related to hip and knee arthroplasties. Methods: A literature review was conducted on databases, and articles published between January 2005 and April 2016 were searched. Findings: A total of 14 articles met the inclusion criteria. Costs were grouped in hospitalization and treatment dimensions. For hospitalization, the indicators were the length of stay (LOS) and/ or monetary costs; For treatment, the indicators were number of surgeries and LOS, or monetary costs. We observed that LOS is the most commonly used to estimate SSI direct costs. Patients who developed hip or knee arthroplasty infections remained in hospital 2.5–3 times longer and incurred hospital costs almost three times higher, when compared with an uninfected patient.