Journal article
Estimating the Attributable Disease Burden and Effects of Interhospital Patient Sharing on Clostridium difficile Infections
Infection control and hospital epidemiology, Vol.40(6), pp.656-661
06/2019
DOI: 10.1017/ice.2019.73
PMID: 30975242
Abstract
To estimate the burden of Clostridium difficile infections (CDIs) due to interfacility patient sharing at regional and hospital levels.
Retrospective observational study.
We used data from the Healthcare Cost and Utilization Project California State Inpatient Database (2005-2011) to identify 26,878,498 admissions and 532,925 patient transfers. We constructed a weighted, directed network among the hospitals by defining an edge between 2 hospitals to be the monthly average number of patients discharged from one hospital and admitted to another on the same day. We then used a network autocorrelation model to study the effect of the patient sharing network on the monthly average number of CDI cases per hospital, and we estimated the proportion of CDI cases attributable to the network.
We found that 13% (95% confidence interval [CI], 7.6%-18%) of CDI cases were due to diffusion through the patient-sharing network. The network autocorrelation parameter was estimated at 5.0 (95% CI, 3.0-6.9). An increase in the number of patients transferred into and/or an increased CDI rate at the hospitals from which those patients originated led to an increase in the number of CDIs in the receiving hospital.
A minority but substantial burden of CDI infections are attributable to hospital transfers. A hospital's infection control may thus be nontrivially influenced by its neighboring hospitals. This work adds to the growing body of evidence that intervention strategies designed to minimize HAIs should be done at the regional rather than local level.
Details
- Title: Subtitle
- Estimating the Attributable Disease Burden and Effects of Interhospital Patient Sharing on Clostridium difficile Infections
- Creators
- Daniel K Sewell - Department of Biostatistics,University of Iowa,Iowa City,IowaJacob E Simmering - Department of Computer Science,University of Iowa,Iowa City,IowaSamuel Justice - Department of Statistics,University of Iowa,Iowa City,IowaSriram V Pemmaraju - Department of Computer Science,University of Iowa,Iowa City,IowaAlberto M Segre - Department of Computer Science,University of Iowa,Iowa City,IowaPhilip M Polgreen - Department of Internal Medicine,University of Iowa,Iowa City,Iowafor the CDC MInD-Healthcare Program
- Resource Type
- Journal article
- Publication Details
- Infection control and hospital epidemiology, Vol.40(6), pp.656-661
- DOI
- 10.1017/ice.2019.73
- PMID
- 30975242
- NLM abbreviation
- Infect Control Hosp Epidemiol
- ISSN
- 0899-823X
- eISSN
- 1559-6834
- Grant note
- U01 CK000531 / NCEZID CDC HHS
- Language
- English
- Date published
- 06/2019
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Infectious Diseases; Health Management and Policy; Epidemiology; Biostatistics; Nursing; Pharmacy Practice and Science; Fraternal Order of Eagles Diabetes Research Center; Injury Prevention Research Center; Computer Science; Public Policy Center (Archive); Internal Medicine
- Record Identifier
- 9984214716102771
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