Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2019 Jun 27;14(1):196.
doi: 10.1186/s13018-019-1224-8.

Economic burden of surgical site infections within the episode of care following joint replacement

Ayoade Adeyemi  1 , Paul Trueman  2
Affiliations
Observational Study

Economic burden of surgical site infections within the episode of care following joint replacement

Ayoade Adeyemi et al. J Orthop Surg Res. .

Abstract

Background: Recent policy initiatives, including Bundled Payments for Care Improvement (BPCI) Initiative by the Centers for Medicare and Medicaid Health Services (CMS), encourage healthcare providers to manage the total episode of care, rather than just the surgical episode. Surgical site infections (SSI) following total joint replacement result in preventable morbidity and suffering for patients and excess healthcare utilization for healthcare providers. This study sought to estimate the additional resources associated with SSIs within the 90-day episode of care following hip and knee joint replacement.

Methods: Using the 2013 Nationwide Readmissions Database (NRD), healthcare resource utilization was compared between propensity score matched patient groups with and without SSI-related readmissions within the 90-day episode of care following total joint replacement.

Results: Surgical site infections were associated with significantly longer hospital length of stay and increased costs following hip and knee joint replacement procedures. Generalized estimating equation regression results confirmed that additional costs associated with SSIs following both cohorts were significant, with additional hospital length of stay and costs following total hip and knee replacement procedures ranging from 4.9 to 5.2 days and $12,689 to $12,890, respectively.

Conclusion: Surgical site infections following total joint replacement account for significant additional healthcare resource use within the 90-day episode of care.

Keywords: Burden; Economic; Surgical site infection; Total joint arthroplasty.

PubMed Disclaimer

Conflict of interest statement

AA & PT are employees of Smith & Nephew, Inc., and may own shares of Smith & Nephew.

Figures

Fig. 1
Fig. 1
Graphic distribution of propensity scores after match in the total hip arthroplasty cohort
Fig. 2
Fig. 2
Graphic distribution of propensity scores before match in the total hip arthroplasty cohort
Fig. 3
Fig. 3
Graphic distribution of propensity scores after match in the total knee arthroplasty cohort
Fig. 4
Fig. 4
Graphic distribution of propensity scores before match in the total knee arthroplasty cohort
See this image and copyright information in PMC

References

    1. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89(4):780–785. - PubMed
    1. Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ. Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res. 2009;467(10):2606–2612. doi: 10.1007/s11999-009-0834-6. - DOI - PMC - PubMed
    1. Kurtz S, Lau E, Halpern M, Ong K. Trend shows growing orthopedic surgery case load. Will surgeons be able to keep up? Mater Manag Health Care. 2006;15(7):61–62. - PubMed
    1. Healy WL, Rana AJ, Iorio R. Hospital economics of primary total knee arthroplasty at a teaching hospital. Clin Orthop Relat Res. 2011;469(1):87–94. doi: 10.1007/s11999-010-1486-2. - DOI - PMC - PubMed
    1. Berstock JR, Beswick AD, Lenguerrand E, Whitehouse MR, Blom AW. Mortality after total hip replacement surgery: A systematic review. Bone Joint Res. 2014;3(6):175–182. doi: 10.1302/2046-3758.36.2000239. - DOI - PMC - PubMed

Publication types