In a recently accepted paper by the Safeguarding Health through Infection Prevention (SHIP) team, PhD student Agi McFarland, Professor Jacqui Reilly, Professor Helen Mason and Dr Sarkis Manoukian highlight a need for more robust evidence base in relation to surgical site infection (SSI) prevention.
SSIs present a significant burden to healthcare and patients in terms of excess length of stay, distress, disability and death. SSI risk and the associated economic burden may be reduced through adherence to prevention guidelines. However, the economics of SSI prevention is not as simple as costs avoided through the elimination of infection. The prevention strategies themselves will incur a cost, and not including these in any analysis will overestimate the economic gains offered by specific strategies.
Through a systematic review of 32 studies, the team found that existing work used a wide range of economic methodologies in various settings to evaluate an inconsistent range of SSI prevention measures. Where reported, the cost per quality life year (QALY) gained from SSI prevention ranged from almost £3000 of savings to over £200,000. Encouragingly, all studies reported some economic benefit associated with preventing SSI although the quality of the studies in the review were found to be low to moderate.
Working alongside the ECONI study team, lead author Agi McFarland aims to address the limitations identified in the paper through her PhD study. She is utilising primary epidemiological and economic data to build an economic model which will examine the economic impact of SSI prevention strategies. The model will evaluate MRSA screening and antibiotic prophylaxis in terms of cost (both in and out with hospital) and patient quality of life.
The full paper can be accessed here: https://doi.org/10.1016/j.jhin.2020.05.011