Background
Patients in home health care (HHC), the fastest growing health care sector, are at
risk for infection. The existing research on infection in HHC is often limited by
small sample sizes, local scope of inquiry, and a lack of current data. There is no
national study examining agency-level infection rates.
Methods
This secondary data analysis used a 20% random sample of the 2010 national Outcome
and Assessment Information Set (OASIS) data. An infection case was identified when
the HHC patient was hospitalized or received emergency care for respiratory infection,
urinary tract infection, intravenous catheter-related infection, wound infection,
or deterioration. Proportions of infection cases out of the total number of patients
were calculated for the whole sample and for each HHC agency.
Results
The final analysis included 199,462 patients from 8,255 HHC agencies. Approximately
3.5% of patients developed infections during their HHC stay, leading to emergency
care treatment or hospitalization. Seventeen percent of unplanned hospitalizations
among HHC patients were caused by infections. The agency-level infection rate ranged
from 0%-34%, with an average of 3.5%.
Conclusion
To our knowledge, this is the first study to examine the proportion of hospitalizations
or emergency care treatment caused by infection in HHC and the agency-level infection
rate at a national level by using OASIS data. These data demonstrate that infection
is a serious problem in HHC, and infection rates varied between agencies. The variance
in agency level rates may be caused by differences in infection control policies and
practices. Better infection surveillance system in HHC is needed to benchmark quality
of care.
Key Words
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Article info
Publication history
Published online: February 10, 2015
Footnotes
Funding/Support: This study is funded by the National Institute of Nursing Research (grant no. R03NR013966-01).
Conflicts of interest: None to report.
Identification
Copyright
© 2015 Published by Elsevier Inc.
