How Can We Estimate the Burden of Healthcare-Associated Infections in Nursing Homes?

Nicola Thompson, PhD, epidemiologist, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, shares what is needed to estimate the burden of healthcare-associated infections in nursing homes.

Interview Transcript (slightly modified for readability):

“There has been a lot of work outside of the United States, in Europe, and also recently in the United States by the Centers for Disease Control and Prevention (CDC) to look at the prevalence of healthcare-associated infections in acute care hospitals. That data that has been collected has been used to translate the prevalence of infection into the burden over the course of the year. That has been done by a long-standing formula that has been out and has been published and used many times. That formula includes in it information on the average length of stay [for a patient].

Essentially the model that is used to estimate the burden of healthcare-associated infections from the prevalence takes into account the average length of hospital stay for people with a healthcare-associated infection, compared [with] the average length of hospital stay for people without a healthcare-associated infection. Those are the pieces for the inputs for the model. The differences between lengths of stay is used to estimate the national burden [of disease].

The concept of ‘length of stay’ does not really hold up when we think about the nursing home setting because the vast majority of people that are in a nursing home go there long-term to receive care and they are not anticipating a discharge. [Therefore,] we need to come up with a different approach to estimating the burden of [healthcare-associated] infections in nursing homes that does not rely on information, or take into account information on length of stay. That is really where the work that has been done by the European CDC (ECDC) to look at the burden estimation in nursing homes has been helpful to us.”