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住院护理中与新生儿血流感染相关的医院和患者特征:来自2019年医疗成本和利用项目儿童数据库的见解

Hospital and Patient Characteristics Associated with Neonatal Blood Stream Infection in Inpatient Care: Insights from the 2019 HCUP KID Database.

作者信息

Samawi Michael, Shah Gulzar H, Kimsey Linda, Waterfield Kristie C, Hendrix Susan

机构信息

Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, GA 30458, USA.

School of Nursing, Waters College of Health Professions, Georgia Southern University, P.O. Box 4158, Savannah, GA 31419, USA.

出版信息

Children (Basel). 2024 Jul 30;11(8):923. doi: 10.3390/children11080923.

Abstract

BACKGROUND

This study explores the associations between pediatric adverse events (PAEs) and both hospital and patient characteristics within the inpatient hospital setting, specifically focusing on Neonatal Blood Stream Infection (NBSI) as defined by pediatric quality indicators (PDIs) from the Agency for Healthcare Research and Quality (AHRQ). This research aims to answer questions regarding the relationship between hospital characteristics and patient demographics with the occurrence of NBSI.

METHODS

This study utilized discharge data from the Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Databases (KID) for the year 2019. Bivariate and multivariate logistic regression models were employed to analyze patient-level encounters of NBSIs. The analysis examined various factors including hospital size, location, and teaching status, as well as patient-specific variables such as gender, age, race, service lines, payment sources, and major operating room procedures.

RESULTS

The results indicate that Public and Private not-for-profit hospitals showed significantly lower odds of experiencing NBSIs when compared to Private investor-owned hospitals, as did smaller, rural, and nonteaching hospitals when compared to large hospitals. Additionally, individual factors such as gender, age, race, service lines, payment sources, and types of major operating room procedures were found to have varying levels of significance in relation to NBSI.

CONCLUSIONS

This study provides important insights into PAEs within the inpatient hospital setting, particularly focusing on NBSIs within the PDI framework. The findings highlight critical areas for the development of evidence-based interventions and guidelines, which are essential for clinicians and policymakers. Ultimately, this study contributes to the understanding and improvement of pediatric patient safety by emphasizing the necessity for targeted strategies to mitigate the risk of NBSI.

摘要

背景

本研究探讨了住院医院环境中儿科不良事件(PAE)与医院及患者特征之间的关联,特别关注医疗保健研究与质量局(AHRQ)的儿科质量指标(PDI)所定义的新生儿血流感染(NBSI)。本研究旨在回答有关医院特征和患者人口统计学与NBSI发生之间关系的问题。

方法

本研究利用了2019年医疗保健成本与利用项目(HCUP)儿童住院数据库(KID)的出院数据。采用双变量和多变量逻辑回归模型分析NBSI的患者层面情况。分析考察了各种因素,包括医院规模、位置和教学状况,以及患者特定变量,如性别、年龄、种族、服务科室、支付来源和主要手术室手术。

结果

结果表明,与私立投资者所有医院相比,公立和私立非营利性医院发生NBSI的几率显著较低,与大型医院相比,规模较小的农村非教学医院也是如此。此外,发现性别、年龄、种族、服务科室、支付来源和主要手术室手术类型等个体因素与NBSI的关联程度各不相同。

结论

本研究为住院医院环境中的PAE提供了重要见解,特别是关注PDI框架内的NBSI。研究结果突出了循证干预措施和指南制定的关键领域,这对临床医生和政策制定者至关重要。最终,本研究通过强调采取针对性策略降低NBSI风险的必要性,有助于理解和改善儿科患者安全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c09/11352803/e7ec58cd1428/children-11-00923-g001.jpg

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