Cost Effectiveness of Infection Control: Surgical Site Infections after Large Bowel Operations

  • IIJIMA Sachiko
    Department of Nursing Administration, Aichi Prefectural College of Nursing and Health Department of Public Health, Graduate School of Medicine, The University of Tokyo
  • HARIHARA Yasushi
    Kanto Medical Center NTT EC
  • KONISHI Toshiro
    Kanto Medical Center NTT EC
  • TANIMURA Hisami
    Kanto Medical Center NTT EC
  • FUKUDA Takashi
    Department of Pharmacoeconomics, Graduate School of Pharmaceutical Sciences, The University of Tokyo

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  • 大腸癌手術症例における手術部位感染予防対策の費用効果分析
  • ダイチョウガン シュジュツ ショウレイ ニ オケル シュジュツ ブイ カンセン ヨボウ タイサク ノ ヒヨウ コウカ ブンセキ

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Abstract

The cost-effectiveness of measures to prevent infection in cases of colon resection were analyzed in a hospital with surgical site infection (SSI) surveillance in patients undergoing colon resection admitted during the period of surveillance introduction (January to June 1999) and a period of stability (July to December 2002). The case attributes and type of infection were evaluated using medical records, nurses specializing in infection control were interviewed with regard to countermeasures against infection in each period, and the per-patient expense of countermeasures against infection and medical fees were calculated.<BR>Major changes in countermeasures against infection from 1999 to 2002 were adherence to a determined duration of administration and type of antimicrobial agent and administration timing in accordance with a clinical path as well as incorporation of subcutaneous lavage with physiological saline. Per-person expenses for countermeasures against infection were reduced from 13, 898 yen in 1999 to 7, 008 yen in 2002 (reduction of 6, 890 yen). The difference in postoperative medical expenses between the infected group and the uninfected group was 738, 000 yen in 1999 and 528, 000 yen in 2002. The infection rate for cases of colon cancer surgery was 28.6% in 1999 and 17.1% in 2002. Per-person expenses required for measures to prevent infection were lower in the period of stability than in the period of surveillance introduction, suggesting that the measures were highly cost-effective.

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