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Dissertation Information for Valerie Watzlaf

NAME:
- Valerie Watzlaf
- (Alias) Valerie Jean Magliocca Watzlaf

DEGREE:
- Ph.D.

DISCIPLINE:
- [No Discipline Recorded]

SCHOOL:
- University of Pittsburgh (USA) (1990)

ADVISORS:
- None

COMMITTEE MEMBERS:
- None

MPACT Status: Incomplete - Not_Inspected

Title: Infections and the cost of hospitalization in the elderly

Abstract: In the Good Health Study non-institutionalized ambulatory elderly individuals were followed to determine the incidence rates, organisms, patterns of transmission and outcomes of clinical infections. In order to further examine patient outcome in relation to cost, length of stay and reimbursement, Good Health Study patient hospitalizations were examined in relation to type of diagnoses and procedures, diagnostic related group (DRG), and infections. The investigator reabstracted the medical record, recoded the diagnoses and procedures and computed a new DRG for each of the hospitalizations. Comparisons of the reabstracted data and the original hospital data were made. For 165 hospitalizations, the investigator and hospital agreed on only 62 percent of all principal diagnostic codes, 28 percent of secondary diagnostic codes, 71 percent of procedure codes and 76 percent of all DRG categories. The investigator found 93 infections in 165 hospitalizations (56%) compared to 67 (41%) for the hospital. These differences demonstrate that the data recorded in the hospital indices and Medicare statistics may not accurately reflect the overall health status of the patient hospitalization.

When differences in cost, length of stay and Medicare reimbursement in hospitalizations with and without infections and in hospitalizations with nosocomial and community-acquired infections were examined, higher average costs and length of stay were seen for hospitalizations with infections. However, when average cost and total payment per day per DRG weight were examined lower average costs and higher gains in dollars were seen in hospitalizations with infections. Also, when the nosocomial infection (an infection occurring after 72 hours) was examined, it was found that sixty-eight percent of all nosocomial infections developed on or after day five and that the risk of infection increased in hospitalizations with longer lengths of stay. Therefore the increase in the length of stay may be causing the nosocomial infection or the actual development of the nosocomial infection may be causing the increase in length of stay.

Future studies are necessary to further examine infections in this elderly population and their effect on cost, length of stay and Medicare reimbursement.

MPACT Scores for Valerie Watzlaf

A = 0
C = 1
A+C = 1
T = 0
G = 0
W = 0
TD = 0
TA = 0
calculated 2009-05-15 11:22:30

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