THE BURDEN OF HEALTHCAREASSOCIATED INFECTIONS IN PRIMARY AND TERTIARY HEALTHCARE WARDS AND THE COST OF PROCEDURE-RELATED PROSTHETIC JOINT INFECTIONS

Healthcare-associated infections (HAI) are infections acquired during treatment in a healthcare
facility. The most common infections are pneumonias, surgical site infections (SSIs) and urinary
tract infections (UTIs). HAIs burden the healthcare system by increasing patient days, the use of
antibiotics, examinations, and thus the costs of care. The occurrence of HAIs can be used to
evaluate the quality of care and to make comparisons between institutions. The purpose of this
dissertation was to evaluate the burden of HAIs in the primary and tertiary healthcare wards and
the costs of procedure-related prosthetic joint infections (PJIs).
The first part of this dissertation evaluated the prevalence of HAIs in the wards of primary
healthcare in the Oulu University Hospital (OUH) district with two point prevalence studies (oneday
sampling) conducted in 2006 and in 2017. In 2006, the study comprised 27 healthcare centres
with 44 wards and 1,294 patients. HAIs were found in 9.3% of the patients. The most common
infections were UTIs, skin and soft tissue infections and lower respiratory tract infections (LRTIs).
In 2017, there were 20 healthcare centres with 34 wards and 764 patients; 9.4% of the patients had
a HAI. The most common HAIs were pneumonias, SSIs and LRTIs.
In the second part, we evaluated the incidence of HAIs in the OUH with a computer-based
electronic infection surveillance program. The study covered 15 adult wards with a total of 353
beds. The overall incidence of HAIs during the six-year study period was 4.5% of discharged
patients. The most common infections were SSIs, pneumonias and UTIs. The surveillance carried
out in this way required a total of one person's workload per year.
The third part evaluated hospital costs of procedure-related PJIs. The study population
consisted of all total knee and hip arthroplasties performed in the OUH from 2013 to 2015: 1,768
patients with 42 PJIs. A PJI tripled the cost of a procedure compared to an arthroplasty without an
infection (€25,100 vs. €7,200). Two-stage revision caused three times more costs than
debridement, antibiotics and implant retention treatment (DAIR) (€53,400 vs. €18,500).
HAIs are common in the wards of primary and tertiary healthcare in the OUH district.
Electronic HAI monitoring is feasible but requires relatively large employer resources.
Postoperative PJI triples the cost of the procedure.


ISBN-10:
9789526219844
Julkaisusarja:
ACTA UNIVERSITATIS OULUENSIS D Medica
Kustantaja:
Oulun yliopisto
Painos:
Osajulkaisuväitöskirjan yhteenveto-osa
Painovuosi:
2018
Tekijät:
PUHTO TEIJA
Viivakoodi 9789526219844
Tuotekoodi 024731
Tekijä PUHTO TEIJA
21,00 €