OBJECTIVES: Surgical site infections (SSIs) occur in up to 11.6% of surgeries, lengthening hospital stays and incurring additional costs. Presurgical antiseptic techniques vary in the rates of SSIs and their impact on a hospital or surgical center's budget. The purpose of this study was to estimate the net budget impact of three antisepsis techniques. METHODS: A budget impact analysis using ISPOR guidelines was completed. Costs associated with DuraPrep, ChloraPrep, and Povidone-Iodine scrub-paint (PI) were obtained from current market sources. Rates of SSIs were derived from published clinical studies. Incremental costs to treat SSIs were derived from literature and adjusted to current U.S. dollars using the medical component of the Consumer Price Index. Presurgical skin preparation time estimates were obtained from product literature and costs calculated based on per minute surgical suite charges. Total cost per 100 surgeries was calculated: [antisepsis cost + costs of presurgical preparation + Incremental costs to treat SSIs (SSI rate X 100 X average cost to treat SSI)]. Estimates were prepared in an interactive spreadsheet to modify cost parameters and rates of SSIs. RESULTS: PI had the lowest product cost but its skin preparation protocol took 5 times longer than DuraPrep or ChloraPrep, resulting in large presurgical expenditures. ChloraPrep was 1.7 times more expensive than DuraPrep per unit but took similar time to apply. DuraPrep provided total cost savings relative to Chloraprep and PI. The total costs per 100 surgeries using DuraPrep, ChloraPrep, and PI were $166,920, $274,508, and $216,500 respectively. The cost savings differences were due to: 1) reduced preparation time (DuraPrep: 3 mins, ChloraPrep: 3 mins, PI: 13 mins); 2) lower SSIs (DuraPrep: 4.8%, ChloraPrep: 8.2%, PI: 4.8%); and 3) per unit product cost difference (DuraPrep: $4.27, ChloraPrep: $7.08, PI: $0.07). CONCLUSIONS: Based on 100 surgeries, DuraPrep provides both time and cost savings relative to PI and ChloraPrep.
Zhou, S., & Carlson, A. (2010). PIN5 A BUDGET IMPACT ANALYSIS OF THREE PRESURGICAL SKIN ANTISEPSIS PROTOCOLS. Value in Health, 13(3), A187. https://doi.org/10.1016/s1098-3015(10)72914-4