Impact of Healthcare-Associated Infections on Length of Stay: A Study in 68 Hospitals in China.

Huixue Jia,Meilian Chen,Xiaoli Luo,Tieying Hou,Huai Yang,Yun Yang,Lili Ding,Anhua Wu,Jianguo Wen,Liuyi Li,Yunxi Liu,Yinghong Wu,Ling Lin,Hongqiu Ma,Weiguang Li,Ying Li,Yawei Xing,Weihong Zhang,Weiping Liu

doi:10.1155/2019/2590563

Abstract

Healthcare-associated infections (HAIs) not only bring additional medical cost to the patients but also prolong the length of stay (LOS). 2119 HAI case-patients and 2119 matched control-patients were identified in 68 hospitals in 14 primary sampling provinces of 7 major regions of China. The HAI caused an increase in stay of 10.4 days. The LOS due to HAI increased from 9.7 to 10.9 days in different levels of hospitals. There was no statistically significant difference in the increased LOS between different hospital levels. The increased LOS due to HAI in different regions was 8.2 to 12.6 days. Comparing between regions, we found that the increased LOS due to HAI in South China is longer than other regions except the Northeast. The gastrointestinal infection (GI) caused the shortest extra LOS of 6.7 days while the BSI caused the longest extra LOS of 12.8 days. The increased LOS for GI was significantly shorter than that of other sites. Among 2119 case-patients, the non-multidrug-resistant pathogens were detected in 365 cases. The average increased LOS due to these bacterial infections was 12.2 days. E. coli infection caused significantly shorter LOS. The studied MDROs, namely, MRSA, VRE, ESBLs-E. coli, ESBLs-KP, CR-E. coli, CR-KP, CR-AB, and CR-PA were detected in 381 cases (18.0%). The average increased LOS due to these MDRO infections was 14 days. Comparing between different MDRO infections, we found that the increased LOS due to HAI caused by CR-PA (26.5 days) is longer than other MDRO infections (shorter than 19.8 days).

Highlights

Healthcare-associated infections (HAIs) threaten the patients’ health and life and bring additional economic burden to the patients and healthcare system including direct economic loss and prolonged hospitalization
There was no significant difference in the increased length of stay (LOS) between different hospital levels (P > 0.05) (Table 1)
We discovered that the increased LOS due to HAI in South China is obviously longer than other regions except the Northeast

Summary

Introduction

Healthcare-associated infections (HAIs) threaten the patients’ health and life and bring additional economic burden to the patients and healthcare system including direct economic loss and prolonged hospitalization. Total hospital length of stay (LOS) is known to be prolonged by the occurrence of HAI. An increased length of stay of 5 days due to HAIs in the ICU was estimated in a study of France [1]. The excess of days of hospitalization for infected patients in ICU was 7.7 days in another study [2]. The extra LOS was 27.1 days, 22.2 days, and 19.2 days for CLABSI, VAP, and CAUTI, respectively, in adult and pediatric ICUs [3]. The mean LOS attributable to CLABSIs was 19 days in another study [4]. The extra length of stay was 3.48 days for BSI, 3.59 days for UTI, 7.23 days for SSI, and 11.52 days for VAP in medical-surgical ICU [2]

Methods

Results

Conclusion