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Measuring the incidence of hospital-acquired complications and their effect on length of stay using CHADx

Kevin M Trentino, Stuart G Swain, Sally A Burrows, Peter C Sprivulis and Frank F S Daly
Med J Aust 2013; 199 (8): 543-547. || doi: 10.5694/mja12.11640

Summary

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.

  • Kevin M Trentino1
  • Stuart G Swain1
  • Sally A Burrows2
  • Peter C Sprivulis3
  • Frank F S Daly4

  • 1 Performance Unit, South Metropolitan Health Service, Perth, WA.
  • 2 School of Medicine and Pharmacology, University of Western Australia, Perth, WA.
  • 3 School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Perth, WA.
  • 4 Royal Perth Group, South Metropolitan Health Service, Perth, WA.


Competing interests:

No relevant disclosures.

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