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American Journal of Medical Quality
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Healthcare-Associated Infections and Length of Hospital Stay in the Medicare Population

Sherrie Dulworth, RN, CPHRM

Milliman USA, New York, sherrie.dulworth{at}milliman.com

Bruce Pyenson, FSA, MAAA

Milliman USA, New York

This study uses cross-sectional analysis of huge Medicare hospital discharge databases to test the hypothesis that hospitals with longer inpatient average lengths of stay (ALOS) will have higher healthcare-associated infection (HAI) rates. For 4 carefully defined and important procedures, the authors investigated the relationship between a hospital's HAI rate and the ALOS for patients who did not have such an infection. The authors found a strong positive correlation between the 2 measures. This finding has important implications for improving patient safety and controlling cost. This article offers hypotheses on the causality of the ALOS-infection rate correlation and suggests ways to test those hypotheses.

Key Words: Cost • healthcare • healthcare-associated infections • hospital • length of stay • nosocomial infections • patient safety

American Journal of Medical Quality, Vol. 19, No. 3, 121-127 (2004)
DOI: 10.1177/106286060401900305
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