“We defined a patient transfer as a patient discharged from one hospital and then admitted to another hospital on the same day.”
The study findings reinforce that infection prevention and control strategies should be conducted at the regional level to better minimize the spread of HAIs, Sewell and colleagues said.
Study findings showed that hospital transfers cause a “minority but substantial burden” of Clostridioides difficile infections in California and that the burden could be reduced by 13% statewide if contamination from hospital transfers was eliminated.
Hospital transfers are known to be associated with the spread of pathogens like C. difficile and MRSA, but researchers said it is critical to better understand the role that hospital transfers play in the spread of hospital-acquired infections, or HAIs.
“The relationship between hospital transfers and higher levels of HAIs is unclear, as is the public health significance of this relationship,” Daniel K. Sewell, PhD, assistant professor of biostatistics in the University of Iowa College of Public Health, and colleagues wrote.
They conducted a retrospective observational study using data collected between 2005 and 2011 from the Healthcare Cost and Utilization Project California State Inpatient Database.
“We were able to discern transfers between hospitals by considering patients who had common discharge and admission dates involving two distinct hospitals,” Sewell and colleagues wrote. “We defined a patient transfer as a patient discharged from one hospital and then admitted to another hospital on the same day.”
According to the study, Sewell and colleagues identified 26,878,498 admissions and 532,925 patient transfers across 385 hospitals. They found that 13% of C. difficile infections (CDIs) were a result of patient transfers (95% CI, 7.6%-18%). Additionally, the researchers observed CDI cases increase at receiving hospitals when the number of transfer patients increased or when the CDI rate at the transferring hospital increased, or both.
“Transfers of patients demonstrate the interconnectedness of health care systems,” they wrote. “Accordingly, efforts to control the spread of infections at one facility may benefit others, and the less rigorous infection control efforts at some hospitals may impact the infection rates at other hospitals within a transfer network.” – by Marley Ghizzone
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