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Racial and Ethnic Disparities in Healthcare-Associated Infections in the United States, 2009–2011

Published online by Cambridge University Press:  10 May 2016

Anila Bakullari
Affiliation:
Qualidigm, Wethersfield, Connecticut
Mark L. Metersky
Affiliation:
Qualidigm, Wethersfield, Connecticut Division of Pulmonary and Critical Care Medicine, University of Connecticut School of Medicine, Farmington, Connecticut
Yun Wang
Affiliation:
Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts
Noel Eldridge
Affiliation:
Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, Maryland
Sheila Eckenrode
Affiliation:
Qualidigm, Wethersfield, Connecticut
Michelle M. Pandolfi
Affiliation:
Qualidigm, Wethersfield, Connecticut
Lisa Jaser
Affiliation:
Qualidigm, Wethersfield, Connecticut Griffin Hospital Pharmacy, Derby, Connecticut
Deron Galusha
Affiliation:
Qualidigm, Wethersfield, Connecticut Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
Ernest Moy
Affiliation:
Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, Maryland
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Background.

Little is known about racial and ethnic disparities in the occurrence of healthcare-associated infections (HAIs) in hospitalized patients.

Objective.

To determine whether racial/ethnic disparities exist in the rate of occurrence of HAIs captured in the Medicare Patient Safety Monitoring System (MPSMS).

Methods.

Chart-abstracted MPSMS data from randomly selected all-payer hospital discharges of adult patients (18 years old or above) between January 1, 2009, and December 31, 2011, for 3 common medical conditions: acute cardiovascular disease (composed of acute myocardial infarction and heart failure), pneumonia, and major surgery for 6 HAI measures (hospital-acquired antibiotic-associated Clostridium difficile, central line-associated bloodstream infections, postoperative pneumonia, catheter-associated urinary tract infections, hospital-acquired methicillin-resistant Staphylococcus aureus, and ventilator-associated pneumonia).

Results.

The study sample included 79,019 patients who had valid racial/ethnic information divided into 6 racial/ethnic groups—white non-Hispanic (n = 62,533), black non-Hispanic (n = 9,693), Hispanic (n = 4,681), Asian (n = 1,225), Native Hawaiian/Pacific Islander (n = 94), and other (n = 793)—who were at risk for at least 1 HAI. The occurrence rate for HAIs was 1.1% for non-Hispanic white patients, 1.3% for non-Hispanic black patients, 1.5% for Hispanic patients, 1.8% for Asian patients, 1.7% for Native Hawaiian/Pacific Islander patients, and 0.70% for other patients. Compared with white patients, the age/gender/comorbidity-adjusted odds ratios of occurrence of HAIs were 1.1 (95% confidence interval [CI], 0.99-1.23), 1.3 (95% CI, 1.15-1.53), 1.4 (95% CI, 1.07-1.75), and 0.7 (95% CI, 0.40-1.12) for black, Hispanic, Asian, and a combined group of Native Hawaiian/Pacific Islander and other patients, respectively.

Conclusions.

Among patients hospitalized with acute cardiovascular disease, pneumonia, and major surgery, Asian and Hispanic patients had significantly higher rates of HAIs than white non-Hispanic patients.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2014

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