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Article: Estimating length of stay and inpatient charges attributable to hospital-acquired bloodstream infections

TitleEstimating length of stay and inpatient charges attributable to hospital-acquired bloodstream infections
Authors
KeywordsHospital-acquired bloodstream infection
Length of stay
Hospital charge
Issue Date2020
PublisherBioMed Central Ltd. The Journal's web site is located at https://aricjournal.biomedcentral.com/
Citation
Antimicrobial Resistance and Infection Control, 2020, v. 9 n. 1, p. article no. e137 How to Cite?
AbstractBackground: Hospital-acquired bloodstream infection (BSI) is associated with high morbidity and mortality and increases patients’ length of stay (LOS) and hospital charges. Our goals were to calculate LOS and charges attributable to BSI and compare results among different models. Methods: A retrospective observational cohort study was conducted in 2017 in a large general hospital, in Beijing. Using patient-level data, we compared the attributable LOS and charges of BSI with three models: 1) conventional non-matching, 2) propensity score matching controlling for the impact of potential confounding variables, and 3) risk set matching controlling for time-varying covariates and matching based on propensity score and infection time. Results: The study included 118,600 patient admissions, 557 (0.47%) with BSI. Six hundred fourteen microorganisms were cultured from patients with BSI. Escherichia coli was the most common bacteria (106, 17.26%). Among multi-drug resistant bacteria, carbapenem-resistant Acinetobacter baumannii (CRAB) was the most common (42, 38.53%). In the conventional non-matching model, the excess LOS and charges associated with BSI were 25.06 days (P < 0.05) and US$22041.73 (P < 0.05), respectively. After matching, the mean LOS and charges attributable to BSI both decreased. When infection time was incorporated into the risk set matching model, the excess LOS and charges were 16.86 days (P < 0.05) and US$15909.21 (P < 0.05), respectively. Conclusion: This is the first study to consider time-dependent bias in estimating excess LOS and charges attributable to BSI in a Chinese hospital setting. We found matching on infection time can reduce bias.
Persistent Identifierhttp://hdl.handle.net/10722/287581
ISSN
2023 Impact Factor: 4.8
2023 SCImago Journal Rankings: 1.256
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorZHANG, Y-
dc.contributor.authorDu, M-
dc.contributor.authorJohnston, JM-
dc.contributor.authorAndres, EB-
dc.contributor.authorSuo, J-
dc.contributor.authorYao, H-
dc.contributor.authorHuo, R-
dc.contributor.authorLiu, Y-
dc.contributor.authorFu, Q-
dc.date.accessioned2020-10-05T12:00:10Z-
dc.date.available2020-10-05T12:00:10Z-
dc.date.issued2020-
dc.identifier.citationAntimicrobial Resistance and Infection Control, 2020, v. 9 n. 1, p. article no. e137-
dc.identifier.issn2047-2994-
dc.identifier.urihttp://hdl.handle.net/10722/287581-
dc.description.abstractBackground: Hospital-acquired bloodstream infection (BSI) is associated with high morbidity and mortality and increases patients’ length of stay (LOS) and hospital charges. Our goals were to calculate LOS and charges attributable to BSI and compare results among different models. Methods: A retrospective observational cohort study was conducted in 2017 in a large general hospital, in Beijing. Using patient-level data, we compared the attributable LOS and charges of BSI with three models: 1) conventional non-matching, 2) propensity score matching controlling for the impact of potential confounding variables, and 3) risk set matching controlling for time-varying covariates and matching based on propensity score and infection time. Results: The study included 118,600 patient admissions, 557 (0.47%) with BSI. Six hundred fourteen microorganisms were cultured from patients with BSI. Escherichia coli was the most common bacteria (106, 17.26%). Among multi-drug resistant bacteria, carbapenem-resistant Acinetobacter baumannii (CRAB) was the most common (42, 38.53%). In the conventional non-matching model, the excess LOS and charges associated with BSI were 25.06 days (P < 0.05) and US$22041.73 (P < 0.05), respectively. After matching, the mean LOS and charges attributable to BSI both decreased. When infection time was incorporated into the risk set matching model, the excess LOS and charges were 16.86 days (P < 0.05) and US$15909.21 (P < 0.05), respectively. Conclusion: This is the first study to consider time-dependent bias in estimating excess LOS and charges attributable to BSI in a Chinese hospital setting. We found matching on infection time can reduce bias.-
dc.languageeng-
dc.publisherBioMed Central Ltd. The Journal's web site is located at https://aricjournal.biomedcentral.com/-
dc.relation.ispartofAntimicrobial Resistance and Infection Control-
dc.rightsAntimicrobial Resistance and Infection Control. Copyright © BioMed Central Ltd.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectHospital-acquired bloodstream infection-
dc.subjectLength of stay-
dc.subjectHospital charge-
dc.titleEstimating length of stay and inpatient charges attributable to hospital-acquired bloodstream infections-
dc.typeArticle-
dc.identifier.emailJohnston, JM: jjohnsto@hku.hk-
dc.identifier.emailAndres, EB: eandres@hku.hk-
dc.identifier.authorityJohnston, JM=rp00375-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/s13756-020-00796-5-
dc.identifier.pmid32811557-
dc.identifier.pmcidPMC7431751-
dc.identifier.scopuseid_2-s2.0-85089643029-
dc.identifier.hkuros315197-
dc.identifier.volume9-
dc.identifier.issue1-
dc.identifier.spagearticle no. e137-
dc.identifier.epagearticle no. e137-
dc.identifier.isiWOS:000566219000001-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl2047-2994-

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