Evaluation of hospitalization for infections that are present on admission

Area of Science:

• Healthcare quality and patient safety
• Infectious disease epidemiology
• Health informatics

Background:

• Hospitals face growing demands for public reporting of infection rates.
• Current public reports often lack "present on admission" (POA) data, hindering the identification of hospital-acquired infections.
• POA status is crucial for accurately assessing infection origins.

Purpose of the Study:

• To evaluate the frequency of POA coding for specific infections: sepsis/septicemia (S-S), methicillin-resistant Staphylococcus aureus (MRSA), and Clostridium difficile infection (CDI).
• To assess the implications of POA coding for public reporting of hospital-acquired infections.
• To advocate for the inclusion of POA status in public infection rate reports.

Main Methods:

• Analysis of "present on admission" (POA) coding designation.
• Inclusion of data from 167 University HealthSystem Consortium hospitals.
• Focus on sepsis/septicemia (S-S), MRSA, and Clostridium difficile infection (CDI).

Main Results:

• 70% of sepsis/septicemia hospitalizations were coded POA.
• 86% of MRSA hospitalizations were coded POA.
• 67% of Clostridium difficile infection hospitalizations were coded POA.

Conclusions:

• A significant proportion of S-S, MRSA, and CDI cases are coded POA, suggesting they are acquired during hospitalization.
• Public reporting of hospital infection rates should incorporate POA status for a more accurate assessment.
• Enhanced collaboration among healthcare organizations and providers is recommended for early identification and prevention of serious infections.