# The Economic Impact of Avoidable Healthcare-Associated Infections on Traumatic Extremity Fracture Patients

> **NIH AHRQ R03** · UNIVERSITY OF MARYLAND BALTIMORE · 2020 · $99,135

## Abstract

ABSTRACT
Of the more than one million Americans that sustain an extremity fracture requiring surgical treatment each
year, over 40,000 patients will endure a subsequent surgical site infection (SSI). The impact of these avoidable
healthcare-associated infections (HAI) on patient income is unknown. The overarching goal of this research is
to determine the effect of a surgical site infection (SSI) on patient income. By linking hospital data with State
tax data, this study will 1) determine the loss in patient income associated with a deep SSI following a
traumatic extremity fracture and 2) describe the heterogeneity in effect of short- and long-term patient
income loss after a post-fracture SSI based on policy-relevant subgroups. Propensity scores will be used
to balance key covariates in patients exposed to an SSI with unexposed patients. Random-effects models will
be used for a longitudinal analysis to estimate the effect of a deep SSI on patient income. Subgroup analyses
will be used to identify patient attributes, based on AHRQ's Priorities Populations, that are associated with an
increased risk of economic loss. Secondary models will censor outcomes at one-, two-, and five-years post-
injury to determine the average economic effect at these time points. The study team has substantial
experience assessing the economic impact of injury and previous experience analyzing the clinical data in this
proposed study. Understanding the full breadth of the economic impact of these adverse events is necessary
to build the case for commensurate patient safety resources and the design of incentives within reimbursement
models. Determining the subgroups that suffer the greatest economic impact of an avoidable HAIs is critical to
the design of specific strategies that mitigate these consequences, such as direct provider reimbursement for
social interventions. Considering the high incidence of fractures in the United States and the increasing
number of surgical procedures performed each year, this study will be critical to benchmarking improvements
in patient safety based on patient economic measures.

## Key facts

- **NIH application ID:** 10125485
- **Project number:** 1R03HS027218-01A1
- **Recipient organization:** UNIVERSITY OF MARYLAND BALTIMORE
- **Principal Investigator:** C. DANIEL MULLINS
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $99,135
- **Award type:** 1
- **Project period:** 2020-09-30 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10125485

## Citation

> US National Institutes of Health, RePORTER application 10125485, The Economic Impact of Avoidable Healthcare-Associated Infections on Traumatic Extremity Fracture Patients (1R03HS027218-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10125485. Licensed CC0.

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