Journal
AMERICAN JOURNAL OF INFECTION CONTROL
Volume 40, Issue 7, Pages 659-662Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.ajic.2011.08.013
Keywords
Surveillance; Multidrug-resistant organisms; Long-term care facilities
Funding
- CDC Prevention Epicenters Program [1U54CK000161]
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Background: Recent exposure to health care facilities is a risk factor for carriage of multidrug-resistant organisms, but identification of hospitalized patients admitted from other health care facilities is often inefficient. Methods: At an acute care hospital, we utilized a standard point of origin code from a universal billing form (UB-04) to categorize hospitalized patients as admitted from any health care facility (long-term care facility vs acute care facility). In a prospective study, the point of origin code and information obtained from physician-documented history were validated against patient self-report. Results: Admission source for 523 patients was assessed. For identifying admission from any health care facility, the point of origin code had 86% sensitivity (95% confidence interval [CI]: 77-92) and 98% specificity (95% CI: 97-99). Physician-documented history had 75% sensitivity (95% CI: 65-84) and 98% specificity (95% CI: 96-99). For identifying patients from long-term care facilities, the sensitivities of the point of origin code and physician history were 50% (95% CI: 23-77) and 71% (95% CI: 42-92), respectively. For identifying patients admitted from acute care facilities, the sensitivities of the point of origin code and physician history were 93% (95% CI: 84-98) and 76% (95% CI: 64-85), respectively. Conclusion: The point of origin code is an accurate method of identifying patients admitted from another health care facility that is comparable with physician-documented history. Copyright (C) 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
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