Inclusion criteria were data from patients 18 years or older and admitted to a participating hospital between January 1, 2016, and December 31, 2019. In other studies the PHD has been used to determine healthcare costs associated with diagnoses such as sepsis, Staphylococcus aureus infections, and acute kidney injury. If charge data were not within 2% of the financial report, it was returned to the hospital for correction. Costs to the hospital for a patient's care were validated against the hospital's own financial reports. Detailed pharmacy data, including brand and generic drug names, were available. Billed services were captured using the ICD-10-CM codes currently used in the United States for admissions after October 2015. Information was collected on hospital characteristics, patient demographics, disease state, and all billed services including medications, diagnostic, and therapeutic services. 13 The database included data from over 1000 hospitals, across all regions of the United States, rural and urban locations and both teaching and nonteaching hospitals, from 2000 through the end of 2019. 13 The PHD is a hospital administration database that at the time of the analysis contained more than 231 million unique patients for approximately 25% of hospital admissions in the United States. This was a retrospective analysis of inpatient data from the Premier Healthcare Database (PHD). The aim of this study was to determine 5 main outcomes including the prevalence of incontinence and treatment of IAD on total cost of care, length of stay (LOS), 30-day readmissions, sacral area pressure injury occurrences for both present on admission (POA) and hospital acquired, and progression of sacral area pressure injuries to a higher stage. Using a highly generalizable and large database of US hospitals, we categorized patients treated for IAD by selecting those patients with a documented urinary and/or fecal incontinence ICD-10-CM code, as well as a documented charge for one or more dermatology products used to treat IAD. Given the absence of an optimal IAD ICD-10-CM code, we employed a novel approach to identify incontinent patients treated for IAD. 7 The critical nature of incontinence in hospitalized patients underscores the importance of understanding the economic costs and healthcare resources necessary to treat incontinent patients and patients with IAD. 10, 11 Yet, incontinence continues to be treated as a hygienic challenge rather than a serious comorbid condition. 9– 11 In addition to skin breakdown, recent evidence has shown urinary incontinence is associated with serious comorbid conditions such as frailty, increased risk of falls, depression, and infections, which contributes to an associated increased risk of mortality. Incontinence and IAD are both independent risk factors for higher stage pressure injuries. 5, 6 Despite high prevalence rates, incontinence and IAD are believed to be underreported due in part to lack of screening, 7 and for IAD, because it lacks an optimal International Classification of Diseases, Tenth Revision, Clinical Modification ( ICD-10-CM) code. 4 Studies have found incontinence prevalence ranges from 18% to 46.6%, and among incontinent patients, prevalence of IAD ranges from 18% to 45.7%. 2, 3 Incontinence-associated dermatitis is characterized by inflammation and/or erosion of the skin from prolonged exposure to urine, stool, or both. 1 Incontinence damages the tissue integrity of the skin, which leaves patients susceptible to skin breakdown such as pressure injuries and incontinence-associated dermatitis (IAD). Urinary and fecal incontinence are common and associated with adverse outcomes in hospitalized patients.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |