The Cost of SSIs

The Costs Associated with a Surgical Infection & Validated IFUs According to the Centers for Disease Control and Prevention (CDC), surgical site infections (SSIs) cost U.S. hospitals well in excess of $4 billion annually. More specifically, SSIs:

• Cost $57,000 per occurrence to resolve a deep organ surgical infection
• Add 11 extra days of hospitalization
• Increase the chance of being placed in the ICU by 60%
• Make it five times more likely to be readmitted to the hospital
• Result in twice the incidence of mortality
• Occur in 2-5% of clean extra-abdominal surgeries and 20% of intra-abdominal surgeries
• Result in approximately 30,000 deaths annually¹

There are 4 distinct types of costs associated with SSIs: direct costs, variable costs, indirect costs and finally, intangible costs. Each of these 4 types of costs has several subsets contained within them.² The direct costs that are incurred when treating an SSI include: Physician and Nursing Personnel; Equipment/Technology; Labor (environmental control, administration, laundry); Utilities.  The variable costs incurred to treat an SSI include, but are not limited to: Medications; Food Consultations; Treatments; Procedures; Devices and Testing (laboratory and radiographic) Supplies. The indirect, and often hidden costs associated with an SSI include: Lost/Wages; Diminished worker productivity on the job; Short term and long term morbidity; Mortality; Income lost by family members; Forgone leisure time; Time spent by family/friends for hospital visits; Travel costs; Home care costs.  The intangible costs associated with an SSI include: Psychological Costs (i.e., anxiety, grief, disability, job loss); Pain and suffering; Change in social functioning/daily activities.³ Research conducted recently by JAMA Internal Medicine found that infections acquired during the course of medical treatment cost U.S. hospitals $9.8 billion annually. According to the report "surgical site infections contribute the most to overall costs, accounting for more than a third of the total. Individual cases of surgical site infections added an average of $20,785 to a patient's medical bills."⁴ The authors of the JAMA study suggested that "a better understanding of the costs of such infections could help health care providers and payers justify investing more in prevention."⁵ One of the more important 'investments' a hospital can make to help reduce their patients' risk of a surgical site infection is to invest in surgical instruments whose cleaning IFUs have been validated to provide clean, sterile, moisture-free instruments on every reprocessing cycle. Given all of the documented costs associated with SSIs, the time has come for hospitals to require all of their instrument suppliers to provide them with the instrument manufacturers’ cleaning IFU validation test results that were conducted by an independent laboratory. In order to be valid, the testing must have been conducted using AAMI, FDA and ANSI cleaning validation testing protocols. Without this level of documented, validated testing of the manufacturers’ cleaning IFUs, it is difficult, if not impossible, to ensure clean, sterile, moisture-free instruments for your patients on every reprocessing cycle.

1. “Guideline For Prevention of Surgical Site Infection” CDC, 1999
2. Haddix, AC and Shaffer PA. Cost-effectiveness Analysis In Prevention Effectiveness: A Guide to Decision Analysis and Economic Evaluation. Oxford University Press, 1996.
3. “The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals” CDC, 2009
4. Journal of the American Medical Association (JAMA), September, 2013
5. Op Cite