Economics of Orthopaedic Infections: A Bottomless Pit

Abstract

In the current socioeconomic environment, where the hospitals are under pressure to decrease costs, the staggering financial and social burden of the hospital-acquired and the Surgical Site Infections, become an important and largely preventable patient safety problem. Cost is a parameter that needs to be considered when clinical practices are assessed. Understanding the true societal costs of the musculoskeletal infections occurring either during the hospital stay or thereafter, is crucial and further research is required with regard to the comparative effectiveness of specific interventions. Infection prevention, early diagnosis, and immediate intervention for an effective management have become a focus of attention for patients, prayers, and regulatory organizations now demanding accountability and reductions in the rates of periprosthetic infections. It is necessary for all Orthopedic surgeons and health care settings to adhere to evidence-based best practices such as prophylactic antibiotic use, surgical site skin-preparation techniques, and hand hygiene rules and also to constantly adhere to all preoperative, intraoperative, and postoperative interventions that could effectively prevent infection. Rigorous economic evaluation and formal cost-effectiveness analysis comparing various infection control and prevention strategies are required, and this research should be conducted from multiple perspectives. Orthopaedic surgeons, the allied infection specialist physicians and researchers should rather engage with health policy makers, funding agencies and the industry in a co-ordinated effort to urgently address the adverse health and economic burden from the musculoskeletal infections, the problem of the antibiotic resistant bacteria, and the scarcity of new classes of antibacterial drugs on the health-care systems and society. It is essential to have priorities and take appropriate measures to decrease mortality and the consumption of the valuable and limited health care resources, sealing the bottom of this “bottomless pit”.