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ORIGINAL RESEARCH article

Front. Public Health
Sec. Health Economics
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1514444
This article is part of the Research Topic Hospital Management and Healthcare Policy: Financing, Resourcing and Accessibility, Volume II View all 21 articles

An evaluation study of direct economic losses from surgical site infections in adults: structural equation modeling

Provisionally accepted
秋霞 左 秋霞 左 1Di Liu Di Liu 2*Baoji Dong Baoji Dong 3*Yuan Zhou Yuan Zhou 4*Kexin Zhao Kexin Zhao 1*Ping Tian Ping Tian 2*
  • 1 Xinjiang Medical University, Ürümqi, China
  • 2 Fifth Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Region, China
  • 3 Sixth Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Region, China
  • 4 People's Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, Xinjiang Uyghur Region, China

The final, formatted version of the article will be published soon.

    Introduction: Surgical site infection (SSI) represents a significant postoperative complication, resulting in extended hospital stays and substantial economic burdens. Previous research on the direct economic impact of SSIs using recursive systems modeling is limited. This study aims to quantify the direct economic losses attributable to SSIs and to dissect the various factors to these losses.A retrospective 1:1 matched case-control study was conducted from January 2023 to March 2024 in three tertiary hospitals in Xinjiang, China. Patients with SSIs were matched on a 1:1 basis by hospital, department, age (±5 years), sex, primary diagnosis, and procedure with controls to form case and control groups. The paired rank sum test was utilized to quantify the direct economic loss from SSIs. Influencing factors were analyzed using a recursive system model.Results: Among the 74,258 patients surveyed, 226 developed SSIs, resulting in an infection rate of 0.3%. The total direct economic loss from SSIs at both hospitals was $467,867, with an average loss of $1,364.37 per SSI patient. SSI patients experienced hospital stays 11 days longer than uninfected patients. Multivariate linear regression identified the duration of hospital stay, catheter and ventilator usage, age, number of surgeries, and duration of antibiotic treatment as influencing factors. Recursive system modeling revealed the indirect contributions of the number of surgeries (indirect effect: 0.074), antibiotic use for 17-36 days (indirect effect: 0.063) and ≥37 days (indirect effect: 0.045), and debridement procedures (indirect effect: 0.054), as well as the direct contributions of hospital days (direct effect: 0.276), indwelling catheter days (direct effect: 0.260), ventilator days (direct effect: 0.221), and age (direct effect: 0.182).Recursive system modeling helped identify the key factors influencing the economic losses from SSIs. These findings provide a theoretical basis for healthcare departments to develop targeted policies.

    Keywords: Surgical site infections, Direct economic loss, recursive system modeling, Influencing factors, Structural equation

    Received: 20 Oct 2024; Accepted: 23 Dec 2024.

    Copyright: © 2024 左, Liu, Dong, Zhou, Zhao and Tian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Di Liu, Fifth Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Region, China
    Baoji Dong, Sixth Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Region, China
    Yuan Zhou, People's Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, 830001, Xinjiang Uyghur Region, China
    Kexin Zhao, Xinjiang Medical University, Ürümqi, China
    Ping Tian, Fifth Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Region, China

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