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Prevalence and burden of orthopaedic implantable-device infections in Italy: a hospital-based national study

BACKGROUND: Healthcare-associated infections (HAIs) represent a serious burden to individual safety and healthcare sustainability. Identifying which patients, procedures and settings are most at risk would offer a significant contribution to HAI management and prevention. The purpose of this study i...

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Autores principales: Pirisi, Luca, Pennestrì, Federico, Viganò, Marco, Banfi, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7216513/
https://www.ncbi.nlm.nih.gov/pubmed/32398027
http://dx.doi.org/10.1186/s12879-020-05065-9
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author Pirisi, Luca
Pennestrì, Federico
Viganò, Marco
Banfi, Giuseppe
author_facet Pirisi, Luca
Pennestrì, Federico
Viganò, Marco
Banfi, Giuseppe
author_sort Pirisi, Luca
collection PubMed
description BACKGROUND: Healthcare-associated infections (HAIs) represent a serious burden to individual safety and healthcare sustainability. Identifying which patients, procedures and settings are most at risk would offer a significant contribution to HAI management and prevention. The purpose of this study is to estimate 1) orthopaedic implantable device-related infection (OIDRI) prevalence in Italian hospitals and 2) the gap between the remuneration paid by the Italian healthcare system and the real costs sustained by Italian hospitals to treat these episodes. METHODS: This is a cross-sectional study based on hospital discharge forms registered in 2012 and 2014. To address the first goal of this study, the national database was investigated to identify 1) surgical procedures associated with orthopaedic device implantation and 2) among them, which patient characteristics (age, sex), type of admission, and type of discharge were associated with a primary diagnosis of infection. To address the second goal, 1) each episode of infection was multiplied by the remuneration paid by the Italian healthcare system to the hospitals, based on the diagnosis-related group (DRG) system, and 2) the total days of hospitalization required to treat the same episodes were multiplied by the average daily cost of hospitalization, according to estimates from the Ministry of the Economy and Finance (MEF). RESULTS: In 2014, 1.55% of the total hospitalizations for orthopaedic device implantation procedures were associated with a main diagnosis of infection, with a negligible increase of 0.04% compared with 2012. Hip and knee replacement revisions, male patients and patients older than 65 years were more exposed to infection. A total of 51.63% of patients were planned admissions to the hospital, 68.75% had an ordinary discharge to home, and 0.9% died. The remuneration paid by the healthcare system to the hospitals was € 37,519,084 in 2014, with 3 DRGs covering 70.6% of the total. The cost of the actual days of hospitalization to treat these episodes was 17.5 million more than the remuneration received. CONCLUSIONS: The OIDRI prevalence was lower than that described in recent surveys in acute care settings, although the numbers were likely underestimated. The cost of treatment varied significantly depending on the remuneration system adopted.
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spelling pubmed-72165132020-05-18 Prevalence and burden of orthopaedic implantable-device infections in Italy: a hospital-based national study Pirisi, Luca Pennestrì, Federico Viganò, Marco Banfi, Giuseppe BMC Infect Dis Research Article BACKGROUND: Healthcare-associated infections (HAIs) represent a serious burden to individual safety and healthcare sustainability. Identifying which patients, procedures and settings are most at risk would offer a significant contribution to HAI management and prevention. The purpose of this study is to estimate 1) orthopaedic implantable device-related infection (OIDRI) prevalence in Italian hospitals and 2) the gap between the remuneration paid by the Italian healthcare system and the real costs sustained by Italian hospitals to treat these episodes. METHODS: This is a cross-sectional study based on hospital discharge forms registered in 2012 and 2014. To address the first goal of this study, the national database was investigated to identify 1) surgical procedures associated with orthopaedic device implantation and 2) among them, which patient characteristics (age, sex), type of admission, and type of discharge were associated with a primary diagnosis of infection. To address the second goal, 1) each episode of infection was multiplied by the remuneration paid by the Italian healthcare system to the hospitals, based on the diagnosis-related group (DRG) system, and 2) the total days of hospitalization required to treat the same episodes were multiplied by the average daily cost of hospitalization, according to estimates from the Ministry of the Economy and Finance (MEF). RESULTS: In 2014, 1.55% of the total hospitalizations for orthopaedic device implantation procedures were associated with a main diagnosis of infection, with a negligible increase of 0.04% compared with 2012. Hip and knee replacement revisions, male patients and patients older than 65 years were more exposed to infection. A total of 51.63% of patients were planned admissions to the hospital, 68.75% had an ordinary discharge to home, and 0.9% died. The remuneration paid by the healthcare system to the hospitals was € 37,519,084 in 2014, with 3 DRGs covering 70.6% of the total. The cost of the actual days of hospitalization to treat these episodes was 17.5 million more than the remuneration received. CONCLUSIONS: The OIDRI prevalence was lower than that described in recent surveys in acute care settings, although the numbers were likely underestimated. The cost of treatment varied significantly depending on the remuneration system adopted. BioMed Central 2020-05-12 /pmc/articles/PMC7216513/ /pubmed/32398027 http://dx.doi.org/10.1186/s12879-020-05065-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Pirisi, Luca
Pennestrì, Federico
Viganò, Marco
Banfi, Giuseppe
Prevalence and burden of orthopaedic implantable-device infections in Italy: a hospital-based national study
title Prevalence and burden of orthopaedic implantable-device infections in Italy: a hospital-based national study
title_full Prevalence and burden of orthopaedic implantable-device infections in Italy: a hospital-based national study
title_fullStr Prevalence and burden of orthopaedic implantable-device infections in Italy: a hospital-based national study
title_full_unstemmed Prevalence and burden of orthopaedic implantable-device infections in Italy: a hospital-based national study
title_short Prevalence and burden of orthopaedic implantable-device infections in Italy: a hospital-based national study
title_sort prevalence and burden of orthopaedic implantable-device infections in italy: a hospital-based national study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7216513/
https://www.ncbi.nlm.nih.gov/pubmed/32398027
http://dx.doi.org/10.1186/s12879-020-05065-9
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