Extra length of stay and costs because of health care–associated infections at a German university hospital

2016 ◽  
Vol 44 (2) ◽  
pp. 160-166 ◽  
Author(s):  
Habibollah Arefian ◽  
Stefan Hagel ◽  
Steffen Heublein ◽  
Florian Rissner ◽  
André Scherag ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
University Hospital ◽  
Health Care Associated Infections

scholarly journals Device associated –health care associated infections monitoring, prevention and cost assessment at intensive care unit of University Hospital in Poland (2015–2017)

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wieslawa Duszynska ◽  
Victor Daniel Rosenthal ◽  
Aleksander Szczesny ◽  
Katarzyna Zajaczkowska ◽  
Michal Fulek ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Acinetobacter Baumannii ◽  
Compliance Rate ◽  
University Teaching ◽  
University Hospital ◽  
Incidence Density ◽  
Infection Group ◽  
Health Care Associated Infections

Abstract Background Device-associated health care-associated infections (DA-HAIs) in intensive care unit (ICU) patients constitute a major therapeutic issue complicating the regular hospitalisation process and having influence on patients’ condition, length of hospitalisation, mortality and therapy cost. Methods The study involved all patients treated > 48 h at ICU of the Medical University Teaching Hospital (Poland) from 1.01.2015 to 31.12.2017. The study showed the surveillance and prevention of DA-HAIs on International Nosocomial Infection Control Consortium (INICC) Surveillance Online System (ISOS) 3 online platform according to methodology of the INICC multidimensional approach (IMA). Results During study period 252 HAIs were found in 1353 (549F/804M) patients and 14,700 patient-days of hospitalisation. The crude infections rate and incidence density of DA-HAIs was 18.69% and 17.49 ± 2.56 /1000 patient-days. Incidence density of ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLA-BSI) and catheter-associated urinary tract infection (CA-UTI) per 1000 device-days were 12.63 ± 1.49, 1.83 ± 0.65 and 6.5 ± 1.2, respectively. VAP(137) constituted 54.4% of HAIs, whereas CA-UTI(91) 36%, CLA-BSI(24) 9.6%.The most common pathogens in VAP and CA-UTI was multidrug-resistant (MDR) Acinetobacter baumannii (57 and 31%), and methicillin-resistant Staphylococcus epidermidis (MRSE) in CLA-BSI (45%). MDR Gram negative bacteria (GNB) 159 were responsible for 63.09% of HAIs. The length of hospitalisation of patients with a single DA-HAI at ICU was 21(14–33) days, while without infections it was 6.0 (3–11) days; p = 0.0001. The mortality rates in the hospital-acquired infection group and no infection group were 26.1% vs 26.9%; p = 0.838; OR 0.9633;95% CI (0.6733–1.3782). Extra cost of therapy caused by one ICU acquired HAI was US$ 11,475/Euro 10,035. Hand hygiene standards compliance rate was 64.7%, while VAP, CLA-BSI bundles compliance ranges were 96.2–76.8 and 29–100, respectively. Conclusions DA-HAIs was diagnosed at nearly 1/5 of patients. They were more frequent than in European Centre Disease Control report (except for CLA-BSI), more frequent than the USA CDC report, yet less frequent than in limited-resource countries (except for CA-UTI). They prolonged the hospitalisation period at ICU and generated substantial additional costs of treatment with no influence on mortality. The Acinetobacter baumannii MDR infections were the most problematic therapeutic issue. DA-HAIs preventive methods compliance rate needs improvement.

scholarly journals The Prevalence of Health Care-Associated Infections and Risk Factors in a University Hospital

Medicina ◽  
2012 ◽  
Vol 48 (8) ◽  
pp. 59 ◽  
Author(s):  
Greta Gailienė ◽  
Zita Gierasimovič ◽  
Daiva Petruševičienė ◽  
Aušra Macijauskienė
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Acute Care ◽  
Prevalence Rate ◽  
Antimicrobial Agents ◽  
Univariate Analysis ◽  
University Hospital ◽  
Stepwise Logistic Regression ◽  
Antimicrobial Use ◽  
Health Care Associated Infections

The aim of the study was to evaluate the prevalence of health care-associated infections, risk factors, and antimicrobial use. Material and Methods. The study was carried out as a point-prevalence study in acute care wards, i.e., intensive care, surgical, and medical wards, at Vilnius University Hospital Santariškių Klinikos in April 2010. The study variables included the patient’s general data, indwelling devices, surgery, infection and its microbiological investigation, and antimicrobial use. All the variables that were logically related or had a P value of <0.25 in the univariate analysis were included in the stepwise logistic regression in order to study the factors potentially associated with health careassociated infections. Results. A total of 731 patients were surveyed. The overall prevalence rate of health care-associated infections was 3.8%. The prevalence of health care-associated infections differed by hospital wards (range 0.0%–19.2%). The lower respiratory tract (32.2%), urinary tract (28.5%), and surgical site infections (32.1%) were the most common health care-associated infections. Moreover, 89.3% of the cases of health care-associated infections were microbiologically investigated. Staphylococcus aureus (28.6%) and Escherichia coli (19.1%) were the most frequently isolated microorganisms. The use of one or more invasive devices was recorded in 332 patients (45.4%). Of the surveyed patients, 20.2% received antimicrobial agents. The most commonly prescribed antimicrobial agents were fluoroquinolones (21.1%), broad-spectrum penicillins (19.1%), and first- or second-generation cephalosporins (18.6%). Conclusions. The prevalence of health care-associated infections was found to be similar to the reported overall prevalence rate of health care-associated infections in acute care hospitals in Lithuania.

scholarly journals Three-year study of health care-associated infections in a Turkish pediatric ward

2014 ◽  
Vol 8 (11) ◽  
pp. 1415-1420 ◽  
Author(s):  
Canan Kuzdan ◽  
Ahmet Soysal ◽  
Gulcan Çulha ◽  
Gulsen Altinkanat ◽  
Guner Soyletir ◽  
...  
Keyword(s):  
Health Care ◽  
Bloodstream Infections ◽  
Blood Stream ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Pediatric Ward ◽  
Control Programmes ◽  
Resistance Patterns ◽  
Health Care Associated Infections ◽  
Tract Infections

Introduction: Health care-associated infections (HCAIs) can cause an increase in morbidity, mortality and costs, especially in developing countries. As information on the epidemiology of HCAIs in pediatric patientsinTurkey is limited, we decided to study the annual incidence and antibiotic resistance patterns in our pediatric ward at Marmara University Hospital. Methodology: All hospitalized patients in the pediatric ward were assessed with regard to HCAIs betweenJanuary 1, 2008 and December 31, 2010. Data was prospectively collected according to standard protocols of the National Nosocomial Infections Surveillance System (NosoLINE). Results: A total of 16.5% of all hospitalized patients developed HCAIs in the three years studied. The most frequent HCAIs were urinary tract infections (UTI) (29.3%), bloodstream infections (27%) and pneumonias (21%). While the most frequent agent isolatedfrom UTI was Escherichia coli (26%), the most common agent in blood stream infections was Staphylococcus epidermidis (30.4%). Vancomycin resistance was found in 73.3% of all Enterococcus faecium strains. Extended-spectrum β-lactamase was detected in 58.3% of Klebsiella pneumoniae and E. coli isolates. Conclusions: Continual HCAI surveillance is important to determineits rate. Knowledge of the HCAI incidence can influence people’s use of broad-spectrum antibiotics and encourage antibiotic rotation. Moreover, the knowledge of HCAI incidence may support the infection control programmes, including education and isolation methods which ultimately may help to reducethe rate of the HCAIs.

scholarly journals Attributable Length of Stay, Mortality Risk, and Costs of Bacterial Health Care–Associated Infections in Australia: A Retrospective Case-cohort Study

2020 ◽  
Author(s):  
X J Lee ◽  
A J Stewardson ◽  
L J Worth ◽  
N Graves ◽  
T M Wozniak
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Hospital Admissions ◽  
Care Hospital ◽  
Retrospective Case ◽  
Health Care Associated Infections ◽  
Tract Infections ◽  
The Impact

Abstract Background Unbiased estimates of the health and economic impacts of health care–associated infections (HAIs) are scarce and focus largely on patients with bloodstream infections (BSIs). We sought to estimate the hospital length of stay (LOS), mortality rate, and costs of HAIs and the differential effects on patients with an antimicrobial-resistant infection. Methods We conducted a multisite, retrospective case-cohort of all acute-care hospital admissions with a positive culture of 1 of the 5 organisms of interest (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, or Enterococcus faecium) from 1 January 2012 through 30 December 2016. Data linkage was used to generate a data set of statewide hospital admissions and pathology data. Patients with bloodstream, urinary, or respiratory tract infections were included in the analysis and matched to a sample of uninfected patients. We used multistate survival models to generate LOS, and logistic regression to derive mortality estimates. Results We matched 20 390 cases to 75 635 uninfected control patients. The overall incidence of infections due to the 5 studied organisms was 116.9 cases per 100 000 patient days, with E. coli urinary tract infections (UTIs) contributing the largest proportion (51 cases per 100 000 patient days). The impact of a UTI on LOS was moderate across the 5 studied pathogens. Resistance significantly increased LOS for patients with third-generation cephalosporin-resistant K. pneumoniae BSIs (extra 4.6 days) and methicillin-resistant S. aureus BSIs (extra 2.9 days). Consequently, the health-care costs of these infections were higher, compared to corresponding drug-sensitive strains. Conclusions The health burden remains highest for BSIs; however, UTIs and respiratory tract infections contributed most to the health-care system expenditure.

scholarly journals Designing Hospital Key Performance Indicators for Academic Centers: Measuring the Average Length of Stay

2016 ◽  
Vol 6 (1) ◽  
pp. 5-11
Author(s):  
Omar A. Ayoub ◽  
Mohamed N. AlAma ◽  
Kamal M. AlGhalayini ◽  
Wesam A. Alhejily ◽  
Mohammed S. Abdulwahab ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Performance Indicator ◽  
Average Length ◽  
Performance Measure ◽  
University Hospital ◽  
Patient Specific ◽  
Design Quality ◽  
Average Length Of Stay ◽  
Risk Patients

Background: Length of stay is an important performance indicator for hospital management and a key measure of health care efficiency. This paper aims to determine the average length of stay in our center and the factors that influence it. We also investigate whether our hospital's length of stay is a key performance measure that can be used to design quality improvement initiatives. Methods: We performed a retrospective analysis of hospitalizations at the Multi-disciplinary Internal Medicine Department of King Abdulaziz University Hospital, Jeddah between 2010 and 2013. We collected data including demographics, admitting diagnosis, admitting unit, treatments administered, and history of transfer from the Intensive Care Unit. Results: The mean length of stay was 5.9 (6.8) days. Patients admitted through the Emergency Department were more likely to have a longer hospital stay compared with those admitted through Day Care or the Outpatient Department (P < 0.001). Expatriates (P < 0.001), bedridden patients (P = 0.02), and those who received prophylaxis for deep venous thrombosis (P < 0.001) were more likely to have a longer length of stay than the rest of the sample. Furthermore, patients admitted in the morning hours had a significantly shorter length of stay than those admitted in the evening hours (P < 0.001). Conclusion: The length of stay among patients at our department is affected by hospital- or patient-specific factors. Health care can be improved by identifying and monitoring the length of stay in high-risk patients.  

scholarly journals National University Hospital discharge survey in the Islamic Republic of Iran

2000 ◽  
Vol 6 (2-3) ◽  
pp. 402-408
Author(s):  
S. M. Reza Khatami ◽  
S. K. Kamrava ◽  
B. Ghatehbaghi ◽  
M. Mirzazadeh
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Hospital Discharge ◽  
Average Length ◽  
Health Care Service ◽  
Health Care Facilities ◽  
University Hospital ◽  
Occupancy Rate ◽  
Bed Occupancy ◽  
Average Length Of Stay

We aimed to determine the rate of hospital discharge, average length of stay and bed occupancy rate in different hospital wards around the country. The survey consisted of health care service activities from 452 university-related hospitals in the country with a total of 59 348 beds. Because of missing data, the use of 56 315 of these beds was analysed. The countrywide discharge rate was 68.32 patients/1000 population per year with an average length of stay of 3.60 days and a bed occupancy rate of 57.44%. The data could be used to design a framework for prediction of inpatient health care facilities needed in the future

scholarly journals Effectiveness of a new short-stay unit for elective low complexity patients’ admissions to improve patient flow

2013 ◽  
Vol 3 (3) ◽  
pp. 44
Author(s):  
Berta Ortiga ◽  
Carlos Bartolome ◽  
Xenia Acebes ◽  
Mari Fe Viso ◽  
Guillem Marca ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Rotation Rate ◽  
University Hospital ◽  
Bivariate Analysis ◽  
Short Stay ◽  
Services Delivery ◽  
Hospital Bed ◽  
Hospital Wards ◽  
Elective Patients

Background/Objective: Specialized care in an acute hospital is the highest resource consuming type of health care. Performance improvement in health care should look for a better application of medical knowledge and resource consuming at the same time as managers locally redesigned processes and organizations in order to be more cost-effective at healthcare services delivery. The aim of this study was to demonstrate the effectiveness of creating a short-stay unit for elective patients as an alternative to the elective patients being admitted in an acute ward. Methods: We included all elective patients admitted in a university hospital between the 1st of January and the 31st of December 2007, as well as those admitted during the same period of 2009, after two hospital wards transformation into a short-stay unit. We used the Hospital General Database for collecting information on years 2007 and 2009. Main key performance indicators were length of stay, pre-surgery length of stay, rotation rate, discharge planning rate and cost. For statistical bivariate analysis, we used a Chi-squared for linear trend for qualitative variables and a T-test and a Wilcoxon signed ranks test and a Mann-Whitney test for non-normal continuous variables. Significance at p < .05 was assumed throughout. Results: We included 10,678 patients, 4,423 during 2007 and 6,255 during 2009. Mean length of stay was 4.3 days (IC 95%: 4.09-4.51) in 2007 and 2.8 days (IC 95%: 2.61-3.01) in 2009 (p < .05). Pre-surgery length of stay was reduced from 0.5 days (IC 95%: 0.44-0.56) in 2007 to 0.2 days (IC 95%: 0.17-0.23) in 2009 (p < .05). The rotation rate was of 92 patients/bed in 2007 and of 126 patients/bed in 2009 (p < .05). The median number of planned discharges grew from 43.05% in 2007 to 86.01% in 2009. Closing two hospital wards at weekends has generated savings of €805,376.32 through the reduction of 22 nurse employees. Conclusions: In conclusion, this approach to hospital bed management in a tertiary hospital has proven both possible and efficient. The creation of short-stay units for elective patient admissions allowed an increase in productivity per hospital bed due to a higher rotation rate and a reduction in human resources costs due to closing hospital wards at weekends. 

Sign in / Sign up

Export Citation Format

Share Document