Background
Healthcare‐associated infections are a major cause for worsening in ischaemic stroke patients. In addition to increased morbidity and mortality, healthcare‐associated infections also result in a potentially preventable increase in economic costs.
Aims
The aim of this study was to identify healthcare‐associated infection incidence in ischaemic stroke patients in Japanese hospitals, and to conduct a risk‐adjusted analysis of the associated economic and clinical outcomes.
Methods
Healthcare‐associated infections were identified in 36 Japanese hospitals using an administrative database. Identification was carried out using a combination of International Classification of Diseases‐10 codes and antibiotic utilisation patterns that indicated the presence of an infection. Risk‐adjusted hospital charges and length of stay were calculated using multiple linear regression analyses correcting for patient and hospital factors. A logistic regression model was used to analyse the association between healthcare‐associated infection infection and mortality.
Results
There was an overall healthcare‐associated infection incidence of 16·4 %, with an interhospital range of 4·7–28·3%. After risk‐adjustment, infected cases paid an additional US$3 067 per admission (interhospital range US$434–US$7 151) and were hospitalised for an additional 16·3‐days (interhospital range: 5·1–25·1‐days) when compared with uninfected patients. Healthcare‐associated infections also had a strongly significant association with increased mortality (odds ratio=23·2, 95% confidence intervals: 12·5–43·2).
Conclusions
We observed a wide range of healthcare‐associated infection incidence between the hospitals. Healthcare‐associated infections were found to be significantly associated with increased hospital charges, length of stay, and mortality. Furthermore, the use of risk‐adjusted multi‐institutional comparisons allowed us to analyse individual performance levels in both infection and cost control.