Patients undergoing gastrointestinal surgery at safety-net hospitals are at increased risk of surgical site infections (SSIs), according to a report. research letter yesterday's JAMA surgery.
Researchers at Memorial Regions Hospital in Florida used data from the National Readmission Database to evaluate SSIs identified during initial hospitalization or readmissions within 90 days after gastrointestinal surgery from 2019 to 2020. did. Safety net hospitals were identified as publicly funded, metropolitan teaching, and large hospitals. Number of beds by region in the United States. To account for risk factors such as age, comorbidities, low household income, and lack of insurance, the researchers performed a propensity score matching analysis.
30% increased risk in safety net hospitals
Of the 392,368 patients identified, 23,447 (6.0%) were treated in safety-net hospitals (mean age 52.4 years, 50.2% female). His overall SSI rate was 3.0%, of which 59.2% of infections were discovered during readmission, whereas his SSI rate at the safety net hospital was 7.8%.
After propensity score matching, the overall SSI rate was 3.5%, and safety net hospitals had nearly 30% increased SSI risk (odds ratio, 1.29; 95% confidence interval, 1.16 to 1.42). SSI risk was higher at all sites in safety-net hospitals (e.g., superficial incisions, deep incisions, organ spaces).
The Centers for Medicare and Medicaid Services (CMS) has been imposing financial penalties on hospitals with high healthcare-associated infection rates since 2014, and previous penalties have been ineffective in reducing infection rates in safety-net hospitals. This finding is noteworthy because it has been proven that there is no. CMS adjusted hospital penalties for readmissions in 2019 to account for socioeconomic differences among patients treated at safety-net hospitals, and study results show similar adjustments are needed for SSI. the study authors say.
