TY - JOUR
T1 - Trends in mortality, length of stay, and hospital charges associated with health care–associated infections, 2006-2012
AU - Glied, Sherry
AU - Cohen, Bevin
AU - Liu, Jianfang
AU - Neidell, Matthew
AU - Larson, Elaine
N1 - Publisher Copyright:
© 2016 Association for Professionals in Infection Control and Epidemiology, Inc.
PY - 2016/9/1
Y1 - 2016/9/1
N2 - 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.
AB - 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.
KW - Health care–associated infections
KW - value-based purchasing
UR - http://www.scopus.com/inward/record.url?scp=84971367737&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84971367737&partnerID=8YFLogxK
U2 - 10.1016/j.ajic.2016.03.010
DO - 10.1016/j.ajic.2016.03.010
M3 - Article
C2 - 27207157
AN - SCOPUS:84971367737
SN - 0196-6553
VL - 44
SP - 983
EP - 989
JO - American Journal of Infection Control
JF - American Journal of Infection Control
IS - 9
ER -