By Dr. Tim Bartholow, WEA Trust Chief Medical Officer
When I think about cost, I think of the money in your wallet and your quality of life. Infection rates drain both. In another blog I mentioned how a surgical site infection (SSI) can appear when you're home and recuperating. Adverse events (like SSIs) in common orthopedic surgeries can send you back to the hospital, adding up to $30,000 to your bill, and adding days and weeks to your recuperation. More complicated SSIs add $100,000 to the cost of care. Some SSIs are even deadly. If this is the first time you're hearing about the real costs and dangers of SSIs and Health care Associated Conditions (HACs), you're not alone. This isn't a topic that often filters down from the providers of care like myself to the average person who needs it. It's not easy to talk about SSIs and HACs, and they aren't really relevant to most of us until we are already heading down a path towards care. My goal with this blog is to try and break the cycle of not enough information.
Time to boost your consumer IQ
My point isn't to make you afraid of surgery. The point is to boost your consumer IQ so you can choose the best hospital or clinic for you.
Time for some good news: hospitals and clinics submit this information to Medicare and it is available for you to review.
This means smart health consumers like you and I can ask our local hospitals for their numbers. Or we can ask our family docs to help us choose a surgery center with the lowest infection rates.
How to know a good infection rate
Even though healthcare teams have techniques for reducing the occurrence of SSIs and HACs, things happen. A hospital's infection rate accounts for adverse events complications from catheters, blood clots, bed sores, etc., plus surgical site infections. When you first see an infection rate number it can look deceptively low and harmless. For instance, just over 3 (3.09) of every 1,000 patients who had ambulatory (out-patient) surgery, were treated within 14 days for a SSI that required hospitalization1. That little "3.09" doesn't sound like much. But remember, SSIs prolong total hospital stays by an average of two weeks, double the chances of being re-hospitalized, and increase the total cost of health care by at least 300 percent2. So you really, really want to avoid contracting an SSI if possible. That's why you have to think about these numbers a little differently. Your goal as a healthcare consumer should always be to minimize your risk. Which means you have to look at comparisons, not just numbers in isolation. Take that previous 3.09 per 1,000 example. Again, doesn't sound too bad right? Well, what if you could choose to receive care where the chance of infection was 1.09 per 1,000? On paper this might seem like a small difference, but you've just reduced your chance of acquiring an infection by 66%. The lesson here? Look for the lowest of the low numbers so you can minimize your risk. Until next time, take good care. -Dr. B
AHRQ: Agency for Healthcare Research and Quality. "AHRQ study shows low rates of serious infections following ambulatory surgery." Press release date: 02/18/2014]
Surgical Site Infections (SSI) Following Orthopedic Surgery by Kimberly Haines, RN, CNOR