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Hospital Infection Rates in St Elsewhere

In: Science

Submitted By mbettridge
Words 5937
Pages 24
Methods
Design and setting
We performed a longitudinal retrospective patient record review study in 21 randomly sampled hospitals in 2004, and 20 in 2008 out of the total of 93 Dutch hospitals. Eight hospitals were studied in both years. Both samples were stratified for hospital type, university, tertiary teaching and general hospitals, and a proper representation of both urban and rural settings in the samples were verified. Tertiary teaching hospitals in The Netherlands provide specialised care and train doctors. The level of care given is between that given in a university hospital and in a general hospital. Generally speaking, university hospitals and, to some extent, tertiary teaching hospitals tend to treat more complex patients with more complex care. To be eligible, hospitals had to have at least 200 beds and an intensive care unit. In each hospital, 400 patient admissions were randomly selected in 2004, and 200 in 2008. Fifty percent of the records were of patients who were discharged from the hospital after a stay of at least 24 h. The other 50% were of patients who died in hospital. These patients were sampled from all inpatient deaths, regardless of their length of stay. We did not exclude patients admitted with an explicitly palliative care plan; this information was noted down and taken into account during the review process. During analysis, overall AE rates were corrected for the oversampling of deceased patients, because in our sample, 50% of the patients were inpatient deaths, and in reality 3%. In the results, we weight our 50% back to the actual 3%, so the presented results are a representation of the total hospital population of discharged and deceased patients. We followed the same procedure for the distribution of types of hospitals. Patients admitted to the psychiatry department, obstetrics and children under 1 year of age were excluded. The...

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