Journal article
Attributable Cost and Length of Stay Associated with Nosocomial Gram-Negative Bacterial Cultures
Antimicrobial Agents and Chemotherapy, Vol.62(11), e00462-18
10/2018
DOI: 10.1128/AAC.00462-18
PMCID: PMC6201096
PMID: 30150480
Abstract
Few studies have estimated the excess inpatient costs due to nosocomial cultures of Gram-negative bacteria (GNB), and those that do are often subject to time-dependent bias. Our objective was to generate estimates of the attributable costs of the underlying infections associated with nosocomial cultures by using a unique inpatient cost data set from the U.S. Few studies have estimated the excess inpatient costs due to nosocomial cultures of Gram-negative bacteria (GNB), and those that do are often subject to time-dependent bias. Our objective was to generate estimates of the attributable costs of the underlying infections associated with nosocomial cultures by using a unique inpatient cost data set from the U.S. Department of Veterans Affairs that allowed us to reduce time-dependent bias. Our study included data from inpatient admissions between 1 October 2007 and 30 November 2010. Nosocomial GNB-positive cultures were defined as clinical cultures positive for Acinetobacter , Pseudomonas , or Enterobacteriaceae between 48 h after admission and discharge. Positive cultures were further classified by site and level of resistance. We conducted analyses using both a conventional approach and an approach aimed at reducing the impact of time-dependent bias. In both instances, we used multivariable generalized linear models to compare the inpatient costs and length of stay for patients with and without a nosocomial GNB culture. Of the 404,652 patients included in the conventional analysis, 12,356 had a nosocomial GNB-positive culture. The excess costs of nosocomial GNB-positive cultures were significant, regardless of specific pathogen, site, or resistance level. Estimates generated using the conventional analysis approach were 32.0% to 131.2% greater than those generated using the approach to reduce time-dependent bias. These results are important because they underscore the large financial burden attributable to these infections and provide a baseline that can be used to assess the impact of improvements in infection control.
Details
- Title: Subtitle
- Attributable Cost and Length of Stay Associated with Nosocomial Gram-Negative Bacterial Cultures
- Creators
- Richard E Nelson - Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USAVanessa W Stevens - Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USAMakoto Jones - Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USAKarim Khader - Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USAMarin L Schweizer - Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USAEli N Perencevich - Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USAMichael A Rubin - Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USAMatthew H Samore - Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Resource Type
- Journal article
- Publication Details
- Antimicrobial Agents and Chemotherapy, Vol.62(11), e00462-18
- Publisher
- American Society for Microbiology; 1752 N St., N.W., Washington, DC
- DOI
- 10.1128/AAC.00462-18
- PMID
- 30150480
- PMCID
- PMC6201096
- ISSN
- 0066-4804
- eISSN
- 1098-6596
- Grant note
- IDEAS Center I50HX001240 / ; VA CDA 11-215 / ; IK2 HX000860-01A2 / ;
- Alternative title
- Costs and LOS with Nosocomial GNB Cultures
- Language
- English
- Date published
- 10/2018
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9983779296602771
Metrics
34 Record Views