OBJECTIVE: Our objective was to estimate the resource utilization and direct medical costs associated with postoperative infections from the private payer perspective in Brazil.

METHODS: A literature review was conducted regarding the cost-of-illness of surgical sites infections segmented as: sternotomy (ST); cardiac surgeries (CS); inguinal incisions (ING); hip, knee, and lower limb trauma (TR); periprosthetic fractures (PF); and revision of hip and knee arthroplasty (REV). No published studies reporting these postoperative costs were found. As such the strategy of a micro-costing construction was carried out, A medical specialist was consulted to validate all procedures. Costs were assigned in a bottom-up approach. Only direct medical costs were considered from Brazilian official price lists in 2021 Brazilian Real (BRL) values. In-hospital and outpatient acute managements related to infectious events were considered. , costs were segmented as in-hospital (daily taxes and new surgical procedures; drug treatment; complementary exams) or those related to outpatient care.

RESULTS: Total costs associated with acute management of surgical site infection were 37,268 BRL (ST); 55,189 BRL (CS); 24,037 BRL (ING); 23,585 BRL (TR); 43,122 BRL (PF); and 69,463 BRL (REV). In-hospital costs were predominant and mainly driven by daily taxes and new surgical procedures in all cases. The second biggest cost drivers were complementary exams in TR and PF, and drug treatment in ST, CS, ING, and REV. Outpatient costs represented 7.6%, 5.2%, 9.8%, 18.8%, 14.8%, and 9.2% for ST, CS, ING, TR, PF, and REV, respectively.

CONCLUSIONS: In the Brazilian private setting, direct costs of surgical site infections are relevant, justifying clinical and economic concerns for payers and society. In the future, new studies with primary data collection should be conducted to assess the economic impact of those infections in a real-world environment.