Hospital readmissions can be costly. In one year alone, 20 percent of Medicare patients readmitted within 30 days of hospital discharge cost an estimated $17.4 billion. Patients infected with one of three strains of bacteria are more likely to be readmitted to the hospital after discharge, according to a new study. Researchers looked back over an 8-year period to identify patients admitted to the hospital, who had a positive bacterial culture result 48 hours or longer after their arrival at the hospital. The focus was on three common hospital-acquired infections: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, and Clostridium difficile. The researchers analyzed the time to hospital readmission after discharge for all adults admitted to the hospital.
The rate of patients who had a clinical culture positive for 1 of the infections was 6 percent, with nearly half of this group (49 percent) having MRSA. Patients with these positive cultures were more likely to be male, older, be in the intensive care unit, have other coexisting conditions, and have longer stays. Within 1 year, 35 percent of those with a positive culture were readmitted to the hospital. Median time to readmission was 27 days compared to 59 days for patients without positive clinical cultures. The 30-day readmission rate was also higher (25 percent) for this group compared to the other group (15 percent).
Even after the researchers adjusted for factors such as age and original length of hospital stay, patients with positive clinical cultures more than 48 hours after admission still had an increased risk of readmission. They recommend that these patients be given additional discharge resources to help them avoid being readmitted to the hospital. The study was supported in part by the Agency for Healthcare Research and Quality (HS21068).
See “Healthcare-associated infections and hospital readmission,” by Carley B. Emerson, M.S., Lindsay M. Eyzaguirre, M.S., Jennifer S. Albrecht, B.A., and others in the June 2012 Infection Control and Hospital Epidemiology 33(6), pp. 539-544.