Sherry Glied1, Bevin Cohen2, Jianfang Liu3, Matthew Neidell4, Elaine Larson3. 1. Robert F. Wagner Graduate School of Public Service, New York University, New York, NY. 2. Columbia University School of Nursing, New York, NY. Electronic address: bac2116@columbia.edu. 3. Columbia University School of Nursing, New York, NY. 4. Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY.
Abstract
BACKGROUND: Many factors associated with hospital-acquired infections (HAIs), including reimbursement policies, drug prices, practice patterns, and the distribution of organisms causing infections, change over time. We examined whether outcomes, including mortality, length of stay (LOS), daily charges, and total charges associated with HAIs, changed during 2006-2012. METHODS: Electronic data on adults discharged from 2 tertiary-quaternary hospitals and 1 community hospital during 2006-2012 were collected retrospectively. Computerized algorithms identified infections using laboratory and administrative codes. Propensity scores were used to match cases with uninfected controls. Differences in mortality, LOS, daily charges, and total charges were modeled against infection status and time period (2006-2008 vs 2009-2012), including interaction for infection status by time period. RESULTS: Among 352,077 discharges, 24,466 HAIs were detected. There was no significant change in mortality. LOS declined only for bloodstream infections (3-day reduction; P < 0.01). Daily charges rose 4% for urinary tract infections but did not change significantly for other HAIs. Total charges declined by 11% for bloodstream infections and 13% for pneumonia. CONCLUSIONS: We found no appreciable or consistent improvement in HAI mortality or LOS during 2006-2012. Costs of bloodstream infections and pneumonia have declined, with most of the change occurring before 2008.
BACKGROUND: Many factors associated with hospital-acquired infections (HAIs), including reimbursement policies, drug prices, practice patterns, and the distribution of organisms causing infections, change over time. We examined whether outcomes, including mortality, length of stay (LOS), daily charges, and total charges associated with HAIs, changed during 2006-2012. METHODS: Electronic data on adults discharged from 2 tertiary-quaternary hospitals and 1 community hospital during 2006-2012 were collected retrospectively. Computerized algorithms identified infections using laboratory and administrative codes. Propensity scores were used to match cases with uninfected controls. Differences in mortality, LOS, daily charges, and total charges were modeled against infection status and time period (2006-2008 vs 2009-2012), including interaction for infection status by time period. RESULTS: Among 352,077 discharges, 24,466 HAIs were detected. There was no significant change in mortality. LOS declined only for bloodstream infections (3-day reduction; P < 0.01). Daily charges rose 4% for urinary tract infections but did not change significantly for other HAIs. Total charges declined by 11% for bloodstream infections and 13% for pneumonia. CONCLUSIONS: We found no appreciable or consistent improvement in HAI mortality or LOS during 2006-2012. Costs of bloodstream infections and pneumonia have declined, with most of the change occurring before 2008.
Authors: Eyal Zimlichman; Daniel Henderson; Orly Tamir; Calvin Franz; Peter Song; Cyrus K Yamin; Carol Keohane; Charles R Denham; David W Bates Journal: JAMA Intern Med Date: 2013 Dec 9-23 Impact factor: 21.873
Authors: Grace M Lee; Ken Kleinman; Stephen B Soumerai; Alison Tse; David Cole; Scott K Fridkin; Teresa Horan; Richard Platt; Charlene Gay; William Kassler; Donald A Goldmann; John Jernigan; Ashish K Jha Journal: N Engl J Med Date: 2012-10-11 Impact factor: 91.245
Authors: Elaine R Cohen; Joe Feinglass; Jeffrey H Barsuk; Cynthia Barnard; Anna O'Donnell; William C McGaghie; Diane B Wayne Journal: Simul Healthc Date: 2010-04 Impact factor: 1.929
Authors: Teresa M Waters; Michael J Daniels; Gloria J Bazzoli; Eli Perencevich; Nancy Dunton; Vincent S Staggs; Catima Potter; Naleef Fareed; Minzhao Liu; Ronald I Shorr Journal: JAMA Intern Med Date: 2015-03 Impact factor: 21.873
Authors: Marcos I Restrepo; Antonio Anzueto; Alejandro C Arroliga; Bekele Afessa; Mark J Atkinson; Ngoc J Ho; Regina Schinner; Ronald L Bracken; Marin H Kollef Journal: Infect Control Hosp Epidemiol Date: 2010-05 Impact factor: 3.254
Authors: Shelley S Magill; Jonathan R Edwards; Wendy Bamberg; Zintars G Beldavs; Ghinwa Dumyati; Marion A Kainer; Ruth Lynfield; Meghan Maloney; Laura McAllister-Hollod; Joelle Nadle; Susan M Ray; Deborah L Thompson; Lucy E Wilson; Scott K Fridkin Journal: N Engl J Med Date: 2014-03-27 Impact factor: 91.245
Authors: Chun Mei Jia; Shun Yi Feng; Yong Li; Zong Xun Cao; Cheng Pu Wu; Yan Zhao Zhai; Jie Cui; Meng Zhang; Jie Gao Journal: Medicine (Baltimore) Date: 2019-12 Impact factor: 1.817
Authors: Daniel Jacobs; Samipya Kafle; Joseph Earles; Rahmatullah Rahmati; Saral Mehra; Benjamin L Judson Journal: Laryngoscope Investig Otolaryngol Date: 2021-01-14