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Potentially Preventable Hospitalizations and the Burden of Healthcare-Associated Infections.

Abstract An estimated 4% of hospital admissions acquired healthcare-associated infections (HAIs) and accounted for $9.8 (USD) billion in direct cost during 2011. In 2010, nearly 140 000 of the 3.5 million potentially preventable hospitalizations (PPHs) may have acquired an HAI. There is a knowledge gap regarding the co-occurrence of these events.
PMID
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Authors

Mayor MeshTerms
Keywords

administrative data

comorbidity

diabetes

healthcare-associated infection

preventable hospitalizations

Journal Title health services research and managerial epidemiology
Publication Year Start




PMID- 28894766
OWN - NLM
STAT- PubMed-not-MEDLINE
DA  - 20170912
LR  - 20170914
IS  - 2333-3928 (Print)
IS  - 2333-3928 (Linking)
VI  - 4
DP  - 2017 Jan-Dec
TI  - Potentially Preventable Hospitalizations and the Burden of Healthcare-Associated 
      Infections.
PG  - 2333392817721109
LID - 10.1177/2333392817721109 [doi]
AB  - BACKGROUND: An estimated 4% of hospital admissions acquired healthcare-associated
      infections (HAIs) and accounted for $9.8 (USD) billion in direct cost during
      2011. In 2010, nearly 140 000 of the 3.5 million potentially preventable
      hospitalizations (PPHs) may have acquired an HAI. There is a knowledge gap
      regarding the co-occurrence of these events. AIMS: To estimate the period
      occurrences and likelihood of acquiring an HAI for the PPH population. METHODS:
      Retrospective, cross-sectional study using logistic regression analysis of 2011
      Texas Inpatient Discharge Public Use Data File including 2.6 million admissions
      from 576 acute care hospitals. Agency for Healthcare Research and Quality
      Prevention Quality Indicator software identified PPH, and existing administrative
      data identification methodologies were refined for Clostridium difficile
      infection, central line-associated bloodstream infection, catheter-associated
      urinary tract infection, and ventilator-associated pneumonia. Odds of acquiring
      HAIs when admitted with PPH were adjusted for demographic, health status,
      hospital, and community characteristics. FINDINGS: We identified 272 923 PPH, 14 
      219 HAI, and 986 admissions with PPH and HAI. Odds of acquiring an HAI for
      diabetic patients admitted for lower extremity amputation demonstrated
      significantly increased odds ratio of 2.9 (95% confidence interval: 2.16-3.91)
      for Clostridium difficile infection. Other PPH patients had lower odds of
      acquiring HAI compared to non-PPH patients, and results were frequently
      significant. CONCLUSIONS: Clinical implications include increased risk of HAI
      among diabetic patients admitted for lower extremity amputation. Methodological
      implications include identification of rare events for inpatient subpopulations
      and the need for improved codification of HAIs to improve cost and policy
      analyses regarding allocation of resources toward clinical improvements.
FAU - Lorden, Andrea L
AU  - Lorden AL
AD  - Department of Health Policy and Management, School of Public Health, Texas A&M
      Health Science Center, College Station, TX, USA.
AD  - Department of Health Administration and Policy, College of Public Health, The
      University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
FAU - Jiang, Luohua
AU  - Jiang L
AD  - Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M 
      Health Science Center, College Station, TX, USA.
AD  - Department of Epidemiology, School of Medicine, The University of California,
      Irvine, CA, USA.
FAU - Radcliff, Tiffany A
AU  - Radcliff TA
AUID- ORCID: 0000-0003-4482-8056
AD  - Department of Health Policy and Management, School of Public Health, Texas A&M
      Health Science Center, College Station, TX, USA.
FAU - Kelly, Kathleen A
AU  - Kelly KA
AD  - Department of Nursing, School of Health Sciences, The Sage Colleges, Troy, NY,
      USA.
FAU - Ohsfeldt, Robert L
AU  - Ohsfeldt RL
AD  - Department of Health Policy and Management, School of Public Health, Texas A&M
      Health Science Center, College Station, TX, USA.
LA  - eng
PT  - Journal Article
DEP - 20170830
PL  - United States
TA  - Health Serv Res Manag Epidemiol
JT  - Health services research and managerial epidemiology
JID - 101654536
PMC - PMC5582652
OTO - NOTNLM
OT  - administrative data
OT  - comorbidity
OT  - diabetes
OT  - healthcare-associated infection
OT  - preventable hospitalizations
COI - Declaration of Conflicting Interests: The author(s) declared no potential
      conflicts of interest with respect to the research, authorship, and/or
      publication of this article.
EDAT- 2017/09/13 06:00
MHDA- 2017/09/13 06:01
CRDT- 2017/09/13 06:00
PHST- 2017/06/02 [received]
PHST- 2017/06/15 [revised]
PHST- 2017/06/15 [accepted]
AID - 10.1177/2333392817721109 [doi]
AID - 10.1177_2333392817721109 [pii]
PST - epublish
SO  - Health Serv Res Manag Epidemiol. 2017 Aug 30;4:2333392817721109. doi:
      10.1177/2333392817721109. eCollection 2017 Jan-Dec.