Estimates of Postoperative Resource Utilization Attributable to Surgical Site Infection in Gastrectomy Patients: Evidence from the JANIS/DPC Integrated Database

Issues of introducing cost-effectiveness analysis in the field of infection control are inevitably controversial. However, cost of illness studies, which are essential for cost-effectiveness analysis, have not been adequately carried out in Japan. This study estimated postoperative resource consumption attributable to surgical site infection (SSI) in gastrectomy patients who underwent gastrectomy between July 2007 and December 2010 at six participating hospitals. The JANIS/DPC Integrated Database was developed after collecting JANIS-related data and administrative DPC data. The generalized linear model was used to estimate excess postoperative length of stay (LOS) and charges (based on fee-for-service) attributable to SSI. A total of 42 SSI cases were identified among 857 surgeries. The generalized linear model was used to estimate the impact of SSI and revealed that compared with non-SSI patients, postoperative LOS and charges increased by 6.6 days and 206,000 yen for superficial SSI patients, 12.8 days and 398,000 yen for deep SSI patients, and 18.3 days and 1,021,000 yen for organ/space SSI patients, respectively. The JANIS/DPC Integrated Database was developed by combining JANIS-related data and DPC data and used to estimate postoperative extra resource consumption in gastrectomy patients at six hospitals. These data may prove useful in cost-effectiveness analysis for future infection control programs in Japan.