Trends in mortality, length of stay, and hospital charges associated with health care–associated infections, 2006-2012

Glied, Sherry; Cohen, Bevin; Liu, Jianfang; Neidell, Matthew; Larson, Elaine

doi:10.1016/j.ajic.2016.03.010

Cited by 32 publications

(34 citation statements)

References 22 publications

(20 reference statements)

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“…According to a point-prevalence survey conducted in 199 hospitals in 2015, pneumonia was the most frequent healthcare-associated infection in the United States, and its prevalence has remained relatively stable in the last few years, compared with the substantial reductions in other nosocomial infections such as surgical site and urinary tract infections (3). Among healthcare-associated infections, pneumonia is the leading cause of death (4).…”

Section: Introductionmentioning

confidence: 99%

Healthcare-Associated Pneumonia: Don't Forget About Respiratory Viruses!

et al. 2019

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Introduction: Healthcare-associated infections are an important cause of morbidity and mortality, are among the most common adverse events in healthcare, and of them, pneumonia is the most commonly reported. Our objective was to evaluate the incidence and clinical outcome of respiratory viruses in hospital-acquired pneumonia (HAP). Methods: This was a prospective cohort study, include patients aged between 0 and 18 who fulfilled Centers for Diseases Control and Prevention (CDC) criteria for HAP. Demographic and clinical data were obtained, and a nasopharyngeal swab specimen was taken for the detection of respiratory viruses. All included patients were monitored until discharge to collect data on the need for mechanical ventilation, intensive care unit (ICU) admission, and mortality. All-cause 30-day mortality was also ascertained. Results: Four thousand three hundred twenty-seven patients were followed for 42,658 patient-days and 5,150 ventilator-days. Eighty-eight patients (2.03%) met the CDC criteria for HAP, 63 patients were included, and clinical and epidemiological characteristics showed no statistically significant differences between patients with virus associated healthcare-associated pneumonia (VAHAP) and those with non-viral healthcare-associated pneumonia (NVHAP). At least one respiratory virus was detected in 65% [95% CI (53–77)] of episodes of HAP, with a single viral pathogen observed in 53.9% and coinfection with 2 viruses in 11.1% of cases. The outcome in terms of ICU admission, mechanical ventilation and the 30-day mortality did not show a significant difference between groups. Conclusions: In two-thirds of the patients a respiratory virus was identified. There was no difference in mortality or the rest of the clinical outcome variables. About half of the patients required mechanical ventilation and 10% died, which emphasizes the importance of considering these pathogens in nosocomial infections, since their identification can influence the decrease in hospital costs and be taken into account in infection control policies.

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Section: Introductionmentioning

confidence: 99%

Healthcare-Associated Pneumonia: Don't Forget About Respiratory Viruses!

et al. 2019

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“…Recently an investigation distributed in 2016 in regards to emergency clinic obtained contamination and creators recommended that the medical clinic procured diseases are the most widely recognized complexity in hospitalized patients, with an expected rate of 4.5 emergency clinic gained contamination per 100 medical clinic affirmations and a yearly cost between $35 billion and $45 billion. Diseases are a main source of death in injury patients (Glied, Cohen, Liu, Neidell, & Larson, 2016).…”

Section: Discussionmentioning

confidence: 99%

Standard Isolation Precautions regarding Nosocomial Infection

2019

JHMN

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The standard precautionary measures, proposed by the United States Centres for Disease Control and Prevention in 1996, are rules for decreasing the danger of transmission of blood-borne and different pathogens in medical profession. The standard precautionary measures characterize that patient blood, body liquid, discharges, and fertilizer have infective germs, and thus disengagement measures are obligatory. Nosocomial infection are the most widely recognized intricacy in hospitalized patients, with an expected frequency of 4.5 health care sectors obtained disease per 100 inpatient admission. Contaminations are a main source of death and furthermore increment the clinic remains of the patients. The focal point of this investigation was investigating systems to decrease Nosocomial contamination. It is noticed that Nosocomial contamination contrarily impacts gainfulness of medical sector. The test for medicinal services chief included giving patients quality consideration, while lessening Nosocomial disease. Social insurance administrator could use their procedures with the discoveries and suggestions of this examination. Human services directors could decrease Nosocomial contamination or continue diminished the rates by executing compelling procedures distinguished in this investigation.

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“…21 Recognizing the limitations of electronic data, we categorized patients as infected, uninfected, or “uncertain,” with the latter excluded to reduce misclassification bias. 21 The BSI cases had at least 1 positive blood culture without the presence of a positive culture with the same organism in another body site in the previous 14 days. Controls had no positive blood cultures or <2 cultures with common skin contaminants.…”

Section: Methodsmentioning

confidence: 99%

“…Calculations included variables used in prior studies of infection risk and were available in our electronic medical record. 6,21 Each patient contributed 1 observation per day in the hospital from day 3 until either the last day in the hospital, the day an infection occurred, or day 40 (because 99% of HAIs occurred prior to day 40). This model was used to generate 1 propensity score (ie, the predicted probability of acquiring an infection on a given day).…”

Section: Methodsmentioning

confidence: 99%

Financial Incentives to Reduce Hospital-Acquired Infections Under Alternative Payment Arrangements

Cohen

Liu

Cohen

et al. 2018

Infect. Control Hosp. Epidemiol.

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Objective The financial incentives for hospitals to improve care may be weaker if higher insurer payments for adverse conditions offset a portion of hospital costs. The purpose of this study was to simulate incentives for reducing hospital-acquired infections under various payment configurations by Medicare, Medicaid, and private payers. Design Matched case-control study. Setting A large, urban hospital system with 1 community hospital and 2 tertiary-care hospitals. Patients All patients discharged in 2013 and 2014. Methods Using electronic hospital records, we identified hospital-acquired bloodstream infections (BSIs) and urinary tract infections (UTIs) with a validated algorithm. We assessed excess hospital costs, length of stay, and payments due to infection, and we compared them to those of uninfected patients matched by propensity for infection. Results In most scenarios, hospitals recovered only a portion of excess HAI costs through increased payments. Patients with UTIs incurred incremental costs of $6,238 (P < .01), while payments increased $1,901 (P < .05) at public diagnosis-related group (DRG) rates. For BSIs, incremental costs were $15,367 (P < .01), while payments increased $7,895 (P < .01). If private payers reimbursed a 200% markup over Medicare DRG rates, hospitals recovered 55% of costs from BSI and UTI among private-pay patients and 54% for BSI and 33% for UTI, respectively, across all patients. Under per-diem payment for private patients with no markup, hospitals recovered 71% of excess costs of BSI and 88% for UTI. At 150% markup and per-diem payments, hospitals profited. Conclusions Hospital incentives for investing in patient safety vary by payer and payment configuration. Higher payments provide resources to improve patient safety, but current payment structures may also reduce the willingness of hospitals to invest in patient safety.

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Trends in mortality, length of stay, and hospital charges associated with health care–associated infections, 2006-2012

Cited by 32 publications

References 22 publications

Healthcare-Associated Pneumonia: Don't Forget About Respiratory Viruses!

Healthcare-Associated Pneumonia: Don't Forget About Respiratory Viruses!

Standard Isolation Precautions regarding Nosocomial Infection

Financial Incentives to Reduce Hospital-Acquired Infections Under Alternative Payment Arrangements

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