title: Trends in mortality, length of stay, and hospital charges associated with health care-associated infections, 2006-2012.
abstract: Many factors associated with hospital-acquired infections (HAIs), including reimbursement policies, drug prices, practice patterns, and the distribution of organisms causing infections, change over time. We examined whether outcomes, including mortality, length of stay (LOS), daily charges, and total charges associated with HAIs, changed during 2006-2012.
  
  
  
  Electronic data on adults discharged from 2 tertiary-quaternary hospitals and 1 community hospital during 2006-2012 were collected retrospectively. Computerized algorithms identified infections using laboratory and administrative codes. Propensity scores were used to match cases with uninfected controls. Differences in mortality, LOS, daily charges, and total charges were modeled against infection status and time period (2006-2008 vs 2009-2012), including interaction for infection status by time period.
  
  
  
  Among 352,077 discharges, 24,466 HAIs were detected. There was no significant change in mortality. LOS declined only for bloodstream infections (3-day reduction; P < 0.01). Daily charges rose 4% for urinary tract infections but did not change significantly for other HAIs. Total charges declined by 11% for bloodstream infections and 13% for pneumonia.
  
  
  
  We found no appreciable or consistent improvement in HAI mortality or LOS during 2006-2012. Costs of bloodstream infections and pneumonia have declined, with most of the change occurring before 2008.
authors.affiliation: Robert F. Wagner Graduate School of Public Service, New York University, New York, NY.
authors.forename: Sherry
authors.initials: S
authors.lastname: Glied
authors.affiliation: Columbia University School of Nursing, New York, NY. Electronic address: bac2116@columbia.edu.
authors.forename: Bevin
authors.initials: B
authors.lastname: Cohen
authors.affiliation: Columbia University School of Nursing, New York, NY.
authors.forename: Jianfang
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY.
authors.forename: Matthew
authors.initials: M
authors.lastname: Neidell
authors.affiliation: Columbia University School of Nursing, New York, NY.
authors.forename: Elaine
authors.initials: E
authors.lastname: Larson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000191:economics* / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D017722:Hospital Charges; D006761:Hospitals; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: Health care–associated infections; value-based purchasing