Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-22T04:42:39.415Z Has data issue: false hasContentIssue false
  • English
  • Français

A Comparison of Administrative Data Versus Surveillance Data for Hospital-Associated Methicillin-Resistant Staphylococcus aureus Infections in Canadian Hospitals

Published online by Cambridge University Press:  20 December 2016

Jessica Y. Ramirez Mendoza ,
Nick Daneman ,
Mary N. Elias ,
Joseph E. Amuah ,
Kathryn Bush ,
Chantal M. Couris  and
Kira Leeb
Jessica Y. Ramirez Mendoza
Affiliation:
Canadian Institute of Health Information, Toronto, Ontario, Canada
Nick Daneman
Affiliation:
Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada Institute of Clinical Evaluative Sciences, Toronto, Ontario, Canada
Mary N. Elias
Affiliation:
Canadian Institute of Health Information, Toronto, Ontario, Canada
Joseph E. Amuah
Affiliation:
Canadian Institute of Health Information, Toronto, Ontario, Canada
Kathryn Bush
Affiliation:
Alberta Health Services Infection Prevention and Control, Calgary, Canada
Chantal M. Couris*
Affiliation:
Canadian Institute of Health Information, Toronto, Ontario, Canada
Kira Leeb
Affiliation:
Canadian Institute of Health Information, Toronto, Ontario, Canada
*
Address correspondence to Chantal Couris, Canadian Institute for Health Information, 4110 Yonge Street Suite 300, Toronto, Ontario, M2P 2B7 ([email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

BACKGROUND

In Canadian hospitals, clinical information is coded according to national coding standards and is routinely collected as administrative data. Administrative data may complement active surveillance programs by providing in-hospital MRSA infection data in a standardized and efficient manner, but only if infections are accurately captured.

OBJECTIVE

To assess the accuracy of administrative data regarding in-hospital bloodstream infections (BSIs) and all-body-site infections due to MRSA.

METHODS

A retrospective study of all (adult and pediatric) in-hospital MRSA infections was conducted by comparing administrative data against surveillance data from 217 acute Canadian hospitals (124 in Ontario, 93 in Alberta) over a 12-month period. Hospital-associated MRSA BSI cases in Ontario, and for all-body-site MRSA infections in Alberta were identified. Pearson correlation coefficients were used to compare the number of hospital-level MRSA cases within administrative versus surveillance datasets. The correlation of all-body-site MRSA infections versus MRSA BSIs was also assessed using the Ontario administrative data.

RESULTS

Strong correlations between hospital-level MRSA cases in administrative and surveillance datasets were identified for Ontario (r=0.79; 95% CI, 0.72–0.85) and Alberta (r=0.92; 95% CI, 0.88–0.94). A strong correlation between all-body-site and bloodstream-only MRSA infection rates was identified across Ontario hospitals (r=0.95; P<.0001; 95% CI, 0.93–0.96).

CONCLUSIONS

This study provides good evidence of the comparability of administrative and surveillance datasets in identifying in-hospital MRSA infections. With standard definitions, administrative data can provide estimates of in-hospital infections for monitoring and/or comparisons across hospitals.

Infect Control Hosp Epidemiol 2017;38:436–443

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 4 , April 2017 , pp. 436 - 443
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. World Health Organization. Antimicrobial Resistance: Global Report on Surveillance. Geneva: WHO Press; 2014.Google Scholar
2. Yoon, HJ, Choi, JY, Kim, CO, Kim, JM, Song, YG. A comparison of clinical features and mortality among methicillin-resistant and methicillin-sensitive strains of Staphylococcus aureus endocarditis. Yonsei Med J 2005;46:496–502.Google Scholar
3. Ontario Agency for Health Protection and Promotion (Public Health Ontario) and Provincial Infectious Diseases Advisory Committee. Best Practices for Surveillance of Health Care-Associated Infections in Patient and Resident Populations. Toronto: Queen’s Printer for Ontario; 2014.Google Scholar
4. Ontario Agency for Health Protection and Promotion (Public Health Ontario) and Provincial Infectious Diseases Advisory Committee. Annex A - Screening, Testing and Surveillance for Antibiotic-Resistant Organisms (AROs). Annexed to: Routine Practices and Additional Precautions in All Health Care Settings. Toronto: Queen’s Printer for Ontario; 2013.Google Scholar
5. Simor, AE, Ofner-Agostini, M, Bryce, E, et al. eds. The evolution of methicillin-resistant Staphylococcus aureus in Canadian hospitals: 5 years of national surveillance. Can Med Assoc 2001;165:21–26.Google Scholar
6. Institute of Health Economics. Canadian Consensus Development Conference: Surveillance and Screening of AROs (Antimicrobial-Resistant Organisms)—Consensus Statement of the Jury. Edmonton: Institute of Health Economics; 2014.Google Scholar
7. Public Health Agency of Canada. Antimicrobial Resistant Organisms (ARO) Surveillance Summary Report for Data From January 1, 2009 to December 31, 2014. Ottawa, Canada: Public Health Agency of Canada; 2015.Google Scholar
8. New hospital-associated methicillin-resistant Staphylococcus aureus (MRSA) bacteremia rate per 1,000 patient days. Health Quality Ontario website. http://indicatorlibrary.hqontario.ca/Indicator/Summary/New-hospital-associated-MRSA-rate/EN. Published 2016. Accessed May 20, 2016.Google Scholar
9. Appendix A: MRSA bacteremia case definition, rate calculation and case reporting thresholds. Ontario Ministry of Health and Long-Term Care website. https://www.oha.com/KnowledgeCentre/Library/Documents/Letter%20from%20John%20McKinlay%20re%20MRSA%20-%20VRE%20Bacteremia.pdf. Published 2008. Accessed March 16, 2015.Google Scholar
10. IPC Surveillance Committee AHS. Provincial Surveillance of Gram-Positive Antibiotic-Resistant Organisms (ARO). Surveillance Protocol. Alberta Health Services; 2012.Google Scholar
11. Canadian Institute for Health Information. Canadian Coding Standards for Version 2012 ICD-10-CA and CCI. Canadian Institute for Health Information; 2012.Google Scholar
12. Canadian Institute for Health Information. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Canada [ICD-10-CA] Version 2012. Ottawa, Canada: Canadian Institute for Health Information; 2012.Google Scholar
13. Indicator Library: Peer Group Methodology. Canadian Institute for Health Information website. http://indicatorlibrary.cihi.ca/download/attachments/1114124/Peer-Group-Methodology_EN.pdf. Published 2016. Accessed November 3, 2016.Google Scholar
14. Daneman, N, Stukel, TA, Ma, X, Vermeulen, M, Guttmann, A. Reduction in Clostridium difficile infection rates after mandatory hospital public reporting: findings from a longitudinal cohort study in Canada. PLoS Med 2012;9:1–11.Google Scholar
15. Kreppel, AJ. Correlation of Discharge Diagnostic Codes With Laboratory-Confirmed Methicillin-Resistant Staphylococcus Aureus Bloodstream Infections at a Large Pediatric Hospital [Dissertation]. Wright State University; 2012.Google Scholar
16. Schweizer, ML, Eber, MR, Laxminarayan, R, et al. Validity of ICD-9-CM coding for identifying incident methicillin-resistant Staphylococcus aureus (MRSA) infections: Is MRSA infection coded as a chronic disease? Infect Control Hosp Epidemiol 2011;32:148–154.Google Scholar
17. Standardized Measures for Infection Control Working Group, Canadian Patient Safety Institute C, and Public Health Agency of Canada. Case Definition and Minimum Data Set for the Surveillance of Methicillin-Resistant Staphylococcus Aureus (MRSA) in Acute Care Hospitals Across Canada. Canada: Public Health Agency of Canada and Canadian Patient Safety Institute; 2009.Google Scholar
18. Leung, V, Lloyd-Smith, E, Romney, M. Classification of MRSA cases detected at the time of hospital admission: does the ‘look-back’ period matter? J Hosp Infect 2013;84:256–258.Google Scholar
19. Kuehnert, MJ, Hill, HA, Kupronis, BA, Tokars, JI, Solomon, SL, Jernigan, DB. Methicillin-resistant Staphylococcus aureus hospitalizations, United States. Emerg Infect Dis 2005;11:868–872.Google Scholar
20. Forrester, L, Collet, JC, Mitchell, R, et al. How reliable are national surveillance data? Findings from an audit of Canadian methicillin-resistant Staphylococcus aureus surveillance data. Am J Infect Control 2012;40:102–107.CrossRefGoogle ScholarPubMed
21. Canadian Institute for Health Information. CIHI Data Quality Study of the 2009–2010 Discharge Abstract Database. Ottawa: Canadian Institute for Health Information; 2012.Google Scholar