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Measuring the incidence of hospital‐acquired complications and their effect on length of stay using CHADx
Author(s) -
Trentino Kevin M,
Swain Stuart G,
Burrows Sally A,
Sprivulis Peter C,
Daly Frank F S
Publication year - 2013
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/mja12.11640
Subject(s) - medicine , incidence (geometry) , complication , emergency medicine , confounding , retrospective cohort study , medical diagnosis , pediatrics , medical emergency , surgery , physics , optics , pathology
Objectives: To use an automated Classification of Hospital Acquired Diagnoses (CHADx) reporting system to report the incidence of hospital‐acquired complications in inpatients and investigate the association between hospital‐acquired complications and hospital length of stay (LOS) in multiday‐stay patients. Design: Retrospective cross‐sectional study for calendar years 2010 and 2011. Setting: South Metropolitan Health Service in Western Australia, which consists of two teaching and three non‐teaching hospitals. Main outcome measures: Incidence of hospital‐acquired complications and mean LOS for multiday‐stay patients. Results: Of 436 841 inpatient separations, 29 172 (6.68%) had at least one hospital‐acquired complication code assigned in the administrative data, and there were a total of 56 326 complication codes. The three most common complications were postprocedural complications; cardiovascular complications; and labour, delivery and postpartum complications. In the subset of data on multiday‐stay patients, crude mean LOS was longer in separations for patients with hospital‐acquired complications than in separations for those without such complications (17.4 days v 5.4 days). After adjusting for potential confounders, separations for patients with hospital‐acquired complications had almost four times the mean LOS of separations for those without such complications (incident rate ratio, 3.84; 95% CI, 3.73–3.96; P < 0.001). Conclusions: An automated CHADx reporting system can be used to collect data on patients with hospital‐acquired complications. Such data can be used to increase emphasis on patient safety and quality of care and identify potential opportunities to reduce LOS.