Estimating extra length of stay due to healthcare-associated infections before and after implementation of a hospital-wide infection control program

PLoS One. 2019 May 17;14(5):e0217159. doi: 10.1371/journal.pone.0217159. eCollection 2019.

Abstract

Introduction: Healthcare-associated infections (HAIs) are a major health concern and have substantial effects on morbidity and mortality and increase healthcare costs. We investigated the effect of a hospital-wide program for the prevention of HAIs on additional length of stay (LOS).

Methods: We analyzed data from a prospective, single-center, quasi-experimental study with two surveillance periods before and after implementation of an infection prevention intervention program. HAI diagnosis was made according to surveillance definition criteria established by the US Centers for Disease Control and Prevention. A multistate model was used to estimate additional LOS for patients with HAI in both surveillance periods.

Results: During the first and second periods, 1,568 and 2,336 HAIs were identified among 26,943 and 35,211 patients, respectively. For HAI patients exclusively treated in a general ward, additional LOS was 8.4 (95% confidence interval, CI: 6.8-10.0) days in the first period and 9.6 (95% CI: 8.3-11.0) days in the second period (p = 0.26). For HAI patients treated in both an intensive care unit (ICU) and a general ward, additional LOS was 8.1 (95% CI: 6.3-9.9) days in the first period to 7.3 (95% CI: 6.1-8.5) days in the second period (p = 0.47).

Conclusions: Healthcare-associated infections prolong LOS. A hospital-wide infection control program did not alter the prolongation of LOS.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cross Infection / economics
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • Female
  • Germany / epidemiology
  • Health Plan Implementation*
  • Hospitals / statistics & numerical data*
  • Humans
  • Infection Control / methods*
  • Intensive Care Units / statistics & numerical data*
  • Length of Stay / statistics & numerical data*
  • Male
  • Middle Aged
  • Non-Randomized Controlled Trials as Topic
  • Prospective Studies

Grants and funding

The CSCC and this research were supported by the German Ministry of Education and Research (BMBF) under grants FKZ 01EO1002 and 01EO1502.