Hospital Clostridium difficile Infection Rates and Prediction of Length of Stay in Patients Without C. difficile Infection

Aaron C Miller; Linnea A Polgreen; Joseph E Cavanaugh; Philip M Polgreen

doi:10.1017/ice.2015.340

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Hospital Clostridium difficile Infection Rates and Prediction of Length of Stay in Patients Without C. difficile Infection

Journal article

Peer reviewed

Hospital Clostridium difficile Infection Rates and Prediction of Length of Stay in Patients Without C. difficile Infection

Aaron C Miller, Linnea A Polgreen, Joseph E Cavanaugh and Philip M Polgreen

Infection control and hospital epidemiology, Vol.37(4), pp.404-410

04/2016

DOI: 10.1017/ice.2015.340

PMCID: PMC5037957

PMID: 26858126

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http://doi.org/10.1017/ice.2015.340View

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Abstract

BACKGROUND Inpatient length of stay (LOS) has been used as a measure of hospital quality and efficiency. Patients with Clostridium difficile infections (CDI) have longer LOS. OBJECTIVE To describe the relationship between hospital CDI incidence and the LOS of patients without CDI. DESIGN Retrospective cohort analysis. METHODS We predicted average LOS for patients without CDI at both the hospital and patient level using hospital CDI incidence. We also controlled for hospital characteristics (eg, bed size) and patient characteristics (eg, comorbidities, age). SETTING Healthcare Cost and Utilization Project Nationwide Inpatient Sample, 2009-2011. PATIENTS The Nationwide Inpatient Sample includes patients from a 20% sample of all nonfederal US hospitals. RESULTS Inpatient LOS was significantly longer (P<.001) at hospitals with greater CDI incidence at both the hospital and individual level. At a hospital level, a percentage point increase in the CDI incidence rate was associated with more than an additional day's stay (between 1.19 and 1.61 days). At the individual level, controlling for all observable variables, a percentage point increase in the CDI incidence rate at their hospital was also associated with longer LOS (between 0.6 and 1.05 additional days). Hospital CDI incidence had a larger impact on LOS than many other commonly used predictors of LOS. CONCLUSION CDI rates are a predictor of LOS in patients without CDI at an individual and institutional level. CDI rates are easy to measure and report and thus may provide an important marker for hospital efficiency and/or quality.

United States

Humans

Male

Clostridium Infections - epidemiology

Clostridium difficile - isolation & purification

Incidence

Young Adult

Hospitals - statistics & numerical data

Adolescent

Adult

Female

Retrospective Studies

Length of Stay - statistics & numerical data

Cross Infection - epidemiology

Details

Title: Subtitle: Hospital Clostridium difficile Infection Rates and Prediction of Length of Stay in Patients Without C. difficile Infection
Creators: Aaron C Miller - 1Cornell College,Mount Vernon,Iowa
Linnea A Polgreen - 2University of Iowa,Iowa City,Iowa
Joseph E Cavanaugh - 2University of Iowa,Iowa City,Iowa
Philip M Polgreen - 2University of Iowa,Iowa City,Iowa
Resource Type: Journal article
Publication Details: Infection control and hospital epidemiology, Vol.37(4), pp.404-410
DOI: 10.1017/ice.2015.340
PMID: 26858126
PMCID: PMC5037957
NLM abbreviation: Infect Control Hosp Epidemiol
ISSN: 1559-6834
eISSN: 1559-6834
Publisher: United States
Grant note: K25 HL122305 / NHLBI NIH HHS K25HL122305 / NHLBI NIH HHS
Language: English
Date published: 04/2016
Academic Unit: Statistics and Actuarial Science; Infectious Diseases; Epidemiology; Economics; Biostatistics; Pharmacy Practice and Science; Injury Prevention Research Center; Internal Medicine
Record Identifier: 9983985966502771

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