Estimation of Cost Associated to an incorrect Surgical Prophilaxis in a Third Leve1 Hospital Center

Abstract

Background: The constant increase of pharmaceutical costs is of great concem to the administrators of the Spanish National Health Service. Antibiotics administered as prophilaxis prior to surgery, play an imponant role in this increase. The compliance of physicians with protocols for chemoprophylaxis is therefore an impottant factor in the control of these pharmaceutical costs. The degree of compliance with the pre-established protocols of prophylaxis prior to surgery are examined in a tertiary level hospital during 1992 and the extra costs due to the lack of compliance with these protocols are estimated using a sample of 371 subjects. The object of this study is to describe the degree of the fulfíllment of the protccols of surgical chemoprophylaxis in a tertiary leve1 hospital and to estimate the minimum additional cost due to the wrong chemoprophylaxis. Methods: A descriptive study was made of the surgical prophylaxis using a sample of 371 subjets. The cost was estimated from the price of the antibiotics administered. Results: A total of 267 (7 1.9% IC95%=67.3-76.5) subjects had received incorrect prophylaxis. The most important causes of incorrect prophylaxis were the wrong antibiotic choice and the excessive duration of their administration. The incorrect prophylaxis was responsible for an additional cost of 1.117.287 ptas. The application of these estimates to the entire 1992 surgical population, at our center, would yield an estimated additional cost of 39.409.965 pesetas. Conclusions: Our health services would have substantial savings if protocols for prophylaxis prior to surgery were strictly followed by physicians.