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2416. Outcomes of Patients with Ventilator-Associated Pneumonia in For-Profit Hospitals Compared to Non-Profit hospitals: A National Retrospective Cohort

BACKGROUND: Healthcare-associated infections (HAI) constitute a significant burden to patient outcomes and healthcare costs. Ventilator-associated pneumonia (VAP) carries a high mortality and represents one of the costliest HAI. There is uncertainty if treating this subgroup of patients in For-Profi...

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Autores principales: Leon, Renato Bobadilla, Morel, Garry Francis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10677975/
http://dx.doi.org/10.1093/ofid/ofad500.2036
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author Leon, Renato Bobadilla
Morel, Garry Francis
author_facet Leon, Renato Bobadilla
Morel, Garry Francis
author_sort Leon, Renato Bobadilla
collection PubMed
description BACKGROUND: Healthcare-associated infections (HAI) constitute a significant burden to patient outcomes and healthcare costs. Ventilator-associated pneumonia (VAP) carries a high mortality and represents one of the costliest HAI. There is uncertainty if treating this subgroup of patients in For-Profit (FP) hospitals portents better outcomes than Nonprofit (NP) hospitals. METHODS: A retrospective cohort of patients admitted from January 2016 through December 2020 was extracted from the National Inpatient Sample database. We compared two cohorts of patients with a primary diagnosis of VAP: patients admitted to FP hospitals and patients admitted to NP hospitals. The primary end-point was all-cause inpatient mortality. A multivariate logistic regression analysis was conducted. The secondary end-points included: comparing the requirement of vasopressor use and Acute Kidney Injury (AKI) requiring hemodialysis (HD); describing associated comorbidities; and comparing if there was a difference in length of stay (LoS) and hospital cost between the 2 groups. In order to compare LoS and hospital cost, a multivariate linear regression was conducted. RESULTS: A total of 6 155 hospitalizations under the primary diagnosis of VAP were included. No statistically significant difference in mortality was noted (FP: 4.24 vs. NP:8; p = 0.182), but age (aOR 1.01, p = 0.020) and Charlson Comorbidity Index(CCI) (aOR 1.20; p < 0.001) were modest predictors of mortality for both groups (FP vs. NP). There was no statistically significant difference in mean LoS between these two groups (FP:10.61 days vs. NP: 9.57, p=0.398). CCI (Coef 0.64, p= 0.01) and admission to large-size hospitals (Coef 3.03, p < 0.001) were predictors of LoS for both groups. Admission to for-profit hospitals predicted higher hospitalization costs (p = 0.020). Furthermore, admission to medium-size hospitals, large-size hospitals, and urban hospitals were also predictors of higher hospital cost (p < 0.05). No statistically significant difference was found in vasopressor use and AKI requiring HD among both groups (FP vs. NP) (p < 0.05). CONCLUSION: Admission to For-Profit hospitals did not portend better outcomes compared to Nonprofit hospitals. Conversely, admission to For-Profit hospitals predicted higher total hospital costs. DISCLOSURES: All Authors: No reported disclosures
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spelling pubmed-106779752023-11-27 2416. Outcomes of Patients with Ventilator-Associated Pneumonia in For-Profit Hospitals Compared to Non-Profit hospitals: A National Retrospective Cohort Leon, Renato Bobadilla Morel, Garry Francis Open Forum Infect Dis Abstract BACKGROUND: Healthcare-associated infections (HAI) constitute a significant burden to patient outcomes and healthcare costs. Ventilator-associated pneumonia (VAP) carries a high mortality and represents one of the costliest HAI. There is uncertainty if treating this subgroup of patients in For-Profit (FP) hospitals portents better outcomes than Nonprofit (NP) hospitals. METHODS: A retrospective cohort of patients admitted from January 2016 through December 2020 was extracted from the National Inpatient Sample database. We compared two cohorts of patients with a primary diagnosis of VAP: patients admitted to FP hospitals and patients admitted to NP hospitals. The primary end-point was all-cause inpatient mortality. A multivariate logistic regression analysis was conducted. The secondary end-points included: comparing the requirement of vasopressor use and Acute Kidney Injury (AKI) requiring hemodialysis (HD); describing associated comorbidities; and comparing if there was a difference in length of stay (LoS) and hospital cost between the 2 groups. In order to compare LoS and hospital cost, a multivariate linear regression was conducted. RESULTS: A total of 6 155 hospitalizations under the primary diagnosis of VAP were included. No statistically significant difference in mortality was noted (FP: 4.24 vs. NP:8; p = 0.182), but age (aOR 1.01, p = 0.020) and Charlson Comorbidity Index(CCI) (aOR 1.20; p < 0.001) were modest predictors of mortality for both groups (FP vs. NP). There was no statistically significant difference in mean LoS between these two groups (FP:10.61 days vs. NP: 9.57, p=0.398). CCI (Coef 0.64, p= 0.01) and admission to large-size hospitals (Coef 3.03, p < 0.001) were predictors of LoS for both groups. Admission to for-profit hospitals predicted higher hospitalization costs (p = 0.020). Furthermore, admission to medium-size hospitals, large-size hospitals, and urban hospitals were also predictors of higher hospital cost (p < 0.05). No statistically significant difference was found in vasopressor use and AKI requiring HD among both groups (FP vs. NP) (p < 0.05). CONCLUSION: Admission to For-Profit hospitals did not portend better outcomes compared to Nonprofit hospitals. Conversely, admission to For-Profit hospitals predicted higher total hospital costs. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2023-11-27 /pmc/articles/PMC10677975/ http://dx.doi.org/10.1093/ofid/ofad500.2036 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstract
Leon, Renato Bobadilla
Morel, Garry Francis
2416. Outcomes of Patients with Ventilator-Associated Pneumonia in For-Profit Hospitals Compared to Non-Profit hospitals: A National Retrospective Cohort
title 2416. Outcomes of Patients with Ventilator-Associated Pneumonia in For-Profit Hospitals Compared to Non-Profit hospitals: A National Retrospective Cohort
title_full 2416. Outcomes of Patients with Ventilator-Associated Pneumonia in For-Profit Hospitals Compared to Non-Profit hospitals: A National Retrospective Cohort
title_fullStr 2416. Outcomes of Patients with Ventilator-Associated Pneumonia in For-Profit Hospitals Compared to Non-Profit hospitals: A National Retrospective Cohort
title_full_unstemmed 2416. Outcomes of Patients with Ventilator-Associated Pneumonia in For-Profit Hospitals Compared to Non-Profit hospitals: A National Retrospective Cohort
title_short 2416. Outcomes of Patients with Ventilator-Associated Pneumonia in For-Profit Hospitals Compared to Non-Profit hospitals: A National Retrospective Cohort
title_sort 2416. outcomes of patients with ventilator-associated pneumonia in for-profit hospitals compared to non-profit hospitals: a national retrospective cohort
topic Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10677975/
http://dx.doi.org/10.1093/ofid/ofad500.2036
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