Infection Control & Hospital Epidemiology
preliminary results demonstrate that previous concerns that the DRG system may create perverse incentives rewarding hospitals for complications may not be justified per se. Second, a high exclusion rate in the CABG group due to loss of follow-up may have led to selection bias. Third, our cost calculations were based on a single national accounting standard, which solely includes direct hospital costs. Fourth, with the present study, we could not analyze the effect of financial incentives (or changing coding practices) on SSI risk. Nonetheless, our results are important because they inform health policy makers regarding the strengths and weaknesses of different payment schemes. In conclusion, hospital costs and earnings of 2 common sur-
gical interventions varied substantially under the DRG pro- spective payment system: SSIs after colon and CABG operations resulted, on average, in higher costs and lower earnings. A pro- spective payment system may add a strong financial incentive to reduce SSI rates after colon and CABG operations. Studies ana- lyzing the financial impact of surgical complications should also report associated earnings.
Supplementary material. To view supplementary material for this article, please visit
https://doi.org/10.1017/ice.2018.179
Acknowledgments.
Financial support. This work was funded by the Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Swit- zerland. J.A.R. was partly funded by a research grant of the University Hos- pital Basel, Basel, Switzerland (‘VW Pool’, Department of Medicine).
Conflicts of interest. All authors report no conflicts of interest relevant to this article.
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