HAI rates among adults trended downward in the United States

Lucado J. HCUP Statistical Brief #94. 2010. AHRQ.

After peaking in 2004 and 2005, healthcare-associated infection rates have declined in recent years, according to data from the Healthcare Cost and Utilization Project, which was summarized in an Agency for Healthcare Research and Quality statistical brief.

The findings are from the 8-year period between 2000 and 2007 and are measured by 1,000 medical and surgical hospital stays. The adjusted rate of infections due to care was 2.03 per 1,000 stays in 2000, increased to a peak of 2.30 in 2004 and 2005, then returned to 2.03 in 2007. The rate in 2006 was 2.19 per 1,000.

The downward trend in the last 4 years was observed in all adult age groups. The highest recorded rate between 2004 and 2007 was 2.58 per 1,000 in individuals aged 45 to 64 years in 2007. The lowest rate was 1.38 per 1,000, which was reported in the 18 to 44 group in 2007.

The 45- to 64-year-old group saw the greatest decline in infection rates between 2004 and 2007, 15.7%.

The report includes data on the most common principal diagnoses for stays with HAIs, which included septicemia, (11.8% of infections had this principal diagnosis); adult respiratory failure (5.9%); and complications of surgical procedures or medical care (4.1%).

Hospitals with the following characteristics were significantly associated with stays for HAIs (P<0.05):

size of 500 or more beds.
location in a metropolitan area.
private, for profit.
teaching hospitals.

Cost analysis results indicated that hospital stays due to HAIs were 19.2 days longer and nearly $43,000 greater than stays without infections, according to the findings.

Other findings indicate that 42,243 patients had HAIs during inpatient hospital stays in 2007, which comprised 0.2% of all hospital stays.

There were 18,995 HAIs among individuals 65 years old and older (45.0%), 13,877 HAIs in the 45 to 64 year group (32.9%) and 9,350 in the 18 to 44 group (22.1%).

Uninsured individuals had the lowest rate of HAIs each year and had the greatest reduction in rates across the study period (24.7%). Patients insured by Medicaid were the most likely to acquire a HAI and experienced the smallest reduction in rates (8.7%).

The report did not include possible explanations for the decreases.