Costing wound infection in a Scottish hospital

Data from a trial of preoperative whole body disinfection in postoperative wound infection prophylaxis involving 3733 patients were used to analyse the cost of a postoperative wound infection. The overall wound infection rate was 14.73% (513/3482), 61% of which were diagnosed after hospital discharge (312 outpatient infections versus 201 inpatient infections). This highlights the prevalence of the transfer of the cost of wound infection to the community. The inpatient and outpatient costs were calculated separately for those with and without a wound infection. Operative procedures were placed into 38 different categories. 12 of these 38 categories accounted for over 90% of the total number of operations performed. Overall, infected patients cost society more than noninfected patients. The hospitalisation costs for inpatients for all categories of patients, whether infected or not, comprised over 99% of the total cost. The excess cost for the infected patients in the study was calculated as 312 915 British pounds sterling (1990 British pounds sterling) or 610 British pounds sterling per infected patient, equivalent to 1926 hospital days overall. For some operations (e.g. stripping varicose veins) an excess of 52 hospital days were associated with wound infection diagnosed after discharge from hospital. Wound infections in some operative categories were consistently more expensive to manage (e.g. excess cost/infected vascular patient = 1085 British pounds sterling) while other operative categories had less costly wound infections (e.g. excess cost/infected thyroid patient = 110 British pounds sterling).(ABSTRACT TRUNCATED AT 250 WORDS)