Cost savings analysis of intrawound vancomycin powder in posterior spinal surgery
| Autor: | Rick Davis, Matthew M. Kang, Charles Gerald T. Ledonio, Brian W. Hill, David W. Polly, Osa Emohare |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Context (language use) Cost Savings Vancomycin Humans Surgical Wound Infection Medicine Orthopedic Procedures Orthopedics and Sports Medicine Antibiotic prophylaxis health care economics and organizations Reimbursement Retrospective Studies business.industry Incidence (epidemiology) Retrospective cohort study Antibiotic Prophylaxis Middle Aged Spine Anti-Bacterial Agents Cost savings Surgery Treatment Outcome Cohort Female Neurology (clinical) business medicine.drug |
| Zdroj: | The Spine Journal. 14:2710-2715 |
| ISSN: | 1529-9430 |
| Popis: | Background context Recent studies have shown that prophylactic use of intrawound vancomycin in posterior instrumented spine surgery substantially decreases the incidence of wound infections requiring repeat surgery. Significant cost savings are thought to be associated with the use of vancomycin in this setting. Purpose To elucidate cost savings associated with the use of intrawound vancomycin in posterior spinal surgeries using a budget-impact model. Study design Retrospective cohort study. Patient sample Data from a cohort of 303 patients who underwent spinal surgery (instrumented and noninstrumented) over 2 years were analyzed; 96 of these patients received prophylactic intrawound vancomycin powder in addition to normal intravenous (IV) antibiotic prophylaxis, and 207 received just routine IV antibiotic prophylaxis. Patients requiring repeat surgical procedures for infection were identified, and the costs of these additional procedures were elucidated. Outcome measure Cost associated with the additional procedure to remediate infection in the absence of vancomycin prophylaxis. Methods We retrospectively reviewed the cost of return procedures for treatment of surgical site infection (SSI). The total reimbursement received by the health care facility was used to model the costs associated with repeat surgery, and this cost was compared with the cost of a single local application of vancomycin costing about $12. Results Of the 96 patients in the treatment group, the return-to-surgery rate for SSI was 0. In the group without vancomycin, seven patients required a total of 14 procedures. The mean cost per episode of surgery, based on the reimbursement, the health care facility received was $40,992 (range, $14,459–$114,763). A total of $573,897 was spent on 3% of the 207-patient cohort that did not receive intrawound vancomycin, whereas a total of $1,152 ($12×96 patients) was spent on the cohort treated with vancomycin. Conclusions This study shows a reduction in SSIs requiring a return-to-surgery—with large cost savings—with use of intrawound vancomycin powder. In our study population, the cost savings totaled more than half a million dollars. |
| Databáze: | OpenAIRE |
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