Quantifying Interhospital Patient Sharing as a Mechanism for Infectious Disease Spread

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dc.contributorVirginia Techen
dc.contributor.authorHuang, Susan S.en
dc.contributor.authorAvery, Takuser R.en
dc.contributor.authorSong, Yeohan H.en
dc.contributor.authorElkins, Kristen R.en
dc.contributor.authorNguyen, Christopher C.en
dc.contributor.authorNutter, Sandra K.en
dc.contributor.authorNafday, Alaka. A.en
dc.contributor.authorCondon, Curtis J.en
dc.contributor.authorChang, Michael T.en
dc.contributor.authorChrest, Daviden
dc.contributor.authorBoos, Johnen
dc.contributor.authorBobashev, Georgiyen
dc.contributor.authorWheaton, Williamen
dc.contributor.authorFrank, Steven A.en
dc.contributor.authorPlatt, Richarden
dc.contributor.authorLipsitch, Marcen
dc.contributor.authorBush, Robin M.en
dc.contributor.authorEubank, Stephenen
dc.contributor.authorBurke, Donald S.en
dc.contributor.authorLee, Bruce Y.en
dc.date.accessed2014-06-26en
dc.date.accessioned2014-06-27T14:45:37Zen
dc.date.available2014-06-27T14:45:37Zen
dc.date.issued2010-11en
dc.description.abstractBACKGROUND. Assessments of infectious disease spread in hospitals seldom account for interfacility patient sharing. This is particularly important for pathogens with prolonged incubation periods or carrier states. METHODS. We quantified patient sharing among all 32 hospitals in Orange County (OC), California, using hospital discharge data. Same-day transfers between hospitals were considered "direct" transfers, and events in which patients were shared between hospitals after an intervening stay at home or elsewhere were considered "indirect" patient-sharing events. We assessed the frequency of readmissions to another OC hospital within various time points from discharge and examined interhospital sharing of patients with Clostridium difficile infection. RESULTS. In 2005, OC hospitals had 319,918 admissions. Twenty-nine percent of patients were admitted at least twice, with a median interval between discharge and readmission of 53 days. Of the patients with 2 or more admissions, 75% were admitted to more than 1 hospital. Ninety-four percent of interhospital patient sharing occurred indirectly. When we used 10 shared patients as a measure of potential interhospital exposure, 6 (19%) of 32 hospitals "exposed" more than 50% of all OC hospitals within 6 months, and 17 (53%) exposed more than 50% within 12 months. Hospitals shared 1 or more patient with a median of 28 other hospitals. When we evaluated patients with C. difficile infection, 25% were readmitted within 12 weeks; 41% were readmitted to different hospitals, and less than 30% of these readmissions were direct transfers. CONCLUSIONS. In a large metropolitan county, interhospital patient sharing was a potential avenue for transmission of infectious agents. Indirect sharing with an intervening stay at home or elsewhere composed the bulk of potential exposures and occurred unbeknownst to hospitals.en
dc.description.sponsorshipNational Institutes of Health U01 GM76672, U01GM070708, U01 GM070698, U01 GM076499, U01GM076497, U01GM070694en
dc.description.sponsorshipUniversity of California Irvineen
dc.description.sponsorshipSanofi-Aventisen
dc.description.sponsorshipGlaxoSmithKlineen
dc.description.sponsorshipPfizeren
dc.description.sponsorshipRocheen
dc.description.sponsorshipTAP Pharmaceuticalsen
dc.identifier.citationSusan S. Huang, Taliser R. Avery et al., "Quantifying Interhospital Patient Sharing as a Mechanism for Infectious Disease Spread," Infection Control and Hospital Epidemiology, Vol. 31, No. 11 (November 2010), pp. 1160-1169. DOI: 10.1086/656747en
dc.identifier.doihttps://doi.org/10.1086/656747en
dc.identifier.issn0899-823Xen
dc.identifier.urihttp://hdl.handle.net/10919/49131en
dc.identifier.urlhttp://www.jstor.org/stable/10.1086/656747en
dc.language.isoen_USen
dc.publisherUniversity of Chicago Pressen
dc.rightsIn Copyrighten
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en
dc.subjectresistant staphylococcus-aureusen
dc.subjectclostridium-difficile infectionen
dc.subjecthealth-care facilitiesen
dc.subjectoutbreaken
dc.subjectimpacten
dc.subjectpublic, environmental & occupational healthen
dc.subjectinfectious diseasesen
dc.titleQuantifying Interhospital Patient Sharing as a Mechanism for Infectious Disease Spreaden
dc.title.serialInfection Control and Hospital Epidemiologyen
dc.typeArticle - Refereeden

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