Background: Today, policy makers are under pressure to improve the quality of care and decrease healthcare costs. Taking into consideration the important effect of adverse events such as Surgical Site Infections (SSI) after Cesarean Section (CS) on both quality and costs of healthcare, implementation of quality improvement programs have became an area of attention. There are increasing evidences that it is possible to improve the quality of provided healthcare, and at the same time reduce the costs.
Objective: To identify, measure, value, and compare the costs and consequences of the New Bundle of Interventions (NBI), a quality improvement program, introduced at the maternity clinic of Bærum Hospital. In addition, it will be investigated if the NBI is cost-effective and increases the net value for the society.
Sample Group: All Cesarean Section patients at the Maternity Clinic of Bærum hospital who experienced surgical site infection, and are registered in the Norwegian Surveillance System for hospital acquired infections (NOIS) between 2006 and 2010.
Method: A Cost-Benefit Analysis (CBA) and a Cost-Effectiveness Analysis (CEA), from both societal and health sector perspective, have been conducted in this study. Surgical site infections after cesarean sections avoided has been used as a measure of effect in CEA analysis, and patient’s maximum stated willingness-to-pay has been used for measuring the monetary value of the human pain and suffering due to SSI after CS.
Results: Based on the data used in this study, implementation of the NBI could reduce the incidence rate of SSI after CS for 9.3%. The NBI showed as incremental cost-effectiveness ratio equal to 599 NOK. The estimated Net Social Benefit (NSB) in monetary terms by reducing the SSI in CS patients is about 2541 NOK. The cost savings for the health sector is estimated about to 637 NOK per CS patient.
The results from CEA and CBA analyses conducted in this study show that the new bundle intervention (NBI) implemented at the maternity clinic of Bærum hospital is beneficial and most likely cost-effective for both society and health sector.Thus, the NBI could improve quality and patient safety by reducing SSI after CS, and could saved costs for both society and health sector.