Study examines hospital transfer structure effect on C. diff: 3 findings

Researchers conducted a study to determine the effect of transfers of patients between different hospitals on the rate of Clostridium difficile infections in a hospital, the results of which were published in Infection Control & Hospital Epidemiology.

The study involved analyzing data on more than 2.7 million transfers from the Healthcare Cost and Utilization Project California State Inpatient Database from 2005 to 2011.

The researchers constructed a series of networks detailing the connections formed by hospitals and computed two measures of connectivity — indegree and weighted indegree — to measure the number of hospitals from which transfers into a hospital arrive, and the total number of incoming transfers, respectively.

Next, they estimated a multivariate model of C. diff infection cases using the log-transformed network measures as well as covariates for hospital fixed effects, log median length of stay, log fraction of patients aged 65 or older and quarter and year indicators as predictors.

Highlighted below are three findings from the study.

1. An increase of one in the log indegree was associated with a 4.8 percent increase in incidence of C. diff infection.

2. An increase of one in the log weighted indegree was associated with a 3.3 percent increase in C. diff infection incidence.

3. The results suggest C. diff infection control is not under the exclusive control of a given hospital but is also influenced by the connections and number of connections that hospitals have with other facilities.



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