Cost–benefit analysis of surveillance for surgical site infection following caesarean section

Objective To estimate the economic burden to the health service of surgical site infection following caesarean section and to identify potential savings achievable through implementation of a surveillance programme.Design Economic model to evaluate the costs and benefits of surveillance from communi...

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Main Authors: Catherine Wloch, Albert Jan Van Hoek, Nathan Green, Joanna Conneely, Pauline Harrington, Elizabeth Sheridan, Jennie Wilson, Theresa Lamagni
Format: Article
Language:English
Published: BMJ Publishing Group 2020-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/7/e036919.full
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author Catherine Wloch
Albert Jan Van Hoek
Nathan Green
Joanna Conneely
Pauline Harrington
Elizabeth Sheridan
Jennie Wilson
Theresa Lamagni
author_facet Catherine Wloch
Albert Jan Van Hoek
Nathan Green
Joanna Conneely
Pauline Harrington
Elizabeth Sheridan
Jennie Wilson
Theresa Lamagni
author_sort Catherine Wloch
collection DOAJ
description Objective To estimate the economic burden to the health service of surgical site infection following caesarean section and to identify potential savings achievable through implementation of a surveillance programme.Design Economic model to evaluate the costs and benefits of surveillance from community and hospital healthcare providers’ perspective.Setting England.Participants Women undergoing caesarean section in National Health Service hospitals.Main outcome measure Costs attributable to treatment and management of surgical site infection following caesarean section.Results The costs (2010) for a hospital carrying out 800 caesarean sections a year based on infection risk of 9.6% were estimated at £18 914 (95% CI 11 521 to 29 499) with 28% accounted for by community care (£5370). With inflation to 2019 prices, this equates to an estimated cost of £5.0 m for all caesarean sections performed annually in England 2018–2019, approximately £1866 and £93 per infection managed in hospital and community, respectively. The cost of surveillance for a hospital for one calendar quarter was estimated as £3747 (2010 costs). Modelling a decrease in risk of infection of 30%, 20% or 10% between successive surveillance periods indicated that a variable intermittent surveillance strategy achieved higher or similar net savings than continuous surveillance. Breakeven was reached sooner with the variable surveillance strategy than continuous surveillance when the baseline risk of infection was 10% or 15% and smaller loses with a baseline risk of 5%.Conclusion Surveillance of surgical site infections after caesarean section with feedback of data to surgical teams offers a potentially effective means to reduce infection risk, improve patient experience and save money for the health service.
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spelling doaj-art-69783fb0b4864dd9b54e210d4c472e3d2024-12-04T12:45:09ZengBMJ Publishing GroupBMJ Open2044-60552020-07-0110710.1136/bmjopen-2020-036919Cost–benefit analysis of surveillance for surgical site infection following caesarean sectionCatherine Wloch0Albert Jan Van Hoek1Nathan Green2Joanna Conneely3Pauline Harrington4Elizabeth Sheridan5Jennie Wilson6Theresa Lamagni7Healthcare Associated Infection and Antimicrobial Resistance, Public Health England, London, UKNational Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control, Bilthoven, The NetherlandsDepartment of Infectious Disease Epidemiology, Imperial College London, London, UKHealthcare Associated Infection and Antimicrobial Resistance, Public Health England, London, UKHealthcare Associated Infection and Antimicrobial Resistance, Public Health England, London, UKHealthcare Associated Infection and Antimicrobial Resistance, Public Health England, London, UKRichard Wells Research Centre, University of West London—Brentford Site, Brentford, UKUnited Kingdom Health Security Agency, London, UKObjective To estimate the economic burden to the health service of surgical site infection following caesarean section and to identify potential savings achievable through implementation of a surveillance programme.Design Economic model to evaluate the costs and benefits of surveillance from community and hospital healthcare providers’ perspective.Setting England.Participants Women undergoing caesarean section in National Health Service hospitals.Main outcome measure Costs attributable to treatment and management of surgical site infection following caesarean section.Results The costs (2010) for a hospital carrying out 800 caesarean sections a year based on infection risk of 9.6% were estimated at £18 914 (95% CI 11 521 to 29 499) with 28% accounted for by community care (£5370). With inflation to 2019 prices, this equates to an estimated cost of £5.0 m for all caesarean sections performed annually in England 2018–2019, approximately £1866 and £93 per infection managed in hospital and community, respectively. The cost of surveillance for a hospital for one calendar quarter was estimated as £3747 (2010 costs). Modelling a decrease in risk of infection of 30%, 20% or 10% between successive surveillance periods indicated that a variable intermittent surveillance strategy achieved higher or similar net savings than continuous surveillance. Breakeven was reached sooner with the variable surveillance strategy than continuous surveillance when the baseline risk of infection was 10% or 15% and smaller loses with a baseline risk of 5%.Conclusion Surveillance of surgical site infections after caesarean section with feedback of data to surgical teams offers a potentially effective means to reduce infection risk, improve patient experience and save money for the health service.https://bmjopen.bmj.com/content/10/7/e036919.full
spellingShingle Catherine Wloch
Albert Jan Van Hoek
Nathan Green
Joanna Conneely
Pauline Harrington
Elizabeth Sheridan
Jennie Wilson
Theresa Lamagni
Cost–benefit analysis of surveillance for surgical site infection following caesarean section
BMJ Open
title Cost–benefit analysis of surveillance for surgical site infection following caesarean section
title_full Cost–benefit analysis of surveillance for surgical site infection following caesarean section
title_fullStr Cost–benefit analysis of surveillance for surgical site infection following caesarean section
title_full_unstemmed Cost–benefit analysis of surveillance for surgical site infection following caesarean section
title_short Cost–benefit analysis of surveillance for surgical site infection following caesarean section
title_sort cost benefit analysis of surveillance for surgical site infection following caesarean section
url https://bmjopen.bmj.com/content/10/7/e036919.full
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