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Publication
Featured researches published by Stephen E. Brossette.
Medical Care | 2008
Meredith L. Kilgore; Kathakali Ghosh; C. Martin Beavers; Daisy Y. Wong; Patrick A. Hymel; Stephen E. Brossette
Background:Although nosocomial infections (NIs) are widely regarded as expensive complications of healthcare delivery, their costs have not been rigorously quantified in large-scale studies. Additionally, problems that can bias cost estimates have often gone unaddressed. For example, are NIs more likely to cause significant extra length of stay (LOS) and costs, or are they more likely to be relatively inexpensive and inevitable consequences of long and expensive hospitalizations? This study is the largest of its kind to provide a rigorous analysis of the costs of NIs. Objective:To precisely bound the attributable costs of a NI using large-scale data and to determine the effects of endogeneity between NIs and LOS on cost estimates. Design, Setting and Patients:Discharge diagnoses, cost, LOS, and NI data were collected for 1,355,347 admissions from March 30, 2001 to January 31, 2006 in 55 hospitals. Main Outcome Measures:The cost effects of NIs (in 2007
American Journal of Infection Control | 2008
Meredith L. Kilgore; Stephen E. Brossette
) were estimated using multivariable regression models. Restricted models were applied to determine how cost estimates are confounded by disease severity and LOS. Results:NIs are associated with
Surgical Endoscopy and Other Interventional Techniques | 2008
Andrew I. Brill; Kathakali Ghosh; Candace Gunnarsson; John A. Rizzo; Terrence Fullum; Craig Maxey; Stephen E. Brossette
12,197 (95% CI,
Archive | 2015
Stephen E. Brossette; Patrick A. Hymel
4862–
Archive | 2005
Stephen E. Brossette; Patrick A. Hymel; Gerald T. Laborde
19,533, P < 0.001) in incremental cost. A lower bound estimate of infection cost, controlling for LOS, is
Archive | 2012
Ning Zheng; Stephen E. Brossette; Patrick A. Hymel; Daisy Y. Wong
4644 (95% CI,
Archive | 2013
Stephen E. Brossette; Ning Zheng; Patrick A. Hymel
1266–
Archive | 2012
Stephen E. Brossette; Patrick A. Hymel; Abel Martinez
7391). Conclusions:NIs are associated with substantial increases in the costs of inpatient care, even when estimates are corrected for potential endogenous confounding.
Archive | 2014
Stephen E. Brossette; Ning Zheng; Patrick A. Hymel
BACKGROUND Hospital-acquired bloodstream infections (BSIs) are relatively rare but do not occur randomly. This suggests that unobserved confounding factors can bias estimates of BSI-associated incremental costs of care. Compared with previous studies, this analysis used a large sample size for greater precision, actual cost-accounting data, and case matching combined with bounding estimates to correct for bias. METHODS Data from 1,355,647 admissions during 69 months in 55 hospitals were collected from a large population database. BSIs were identified by the Nosocomial Infection Marker, a well-validated, electronic, laboratory-based marker used for automatic infection surveillance. Costs were obtained by matching laboratory data with hospital accounting system calculations and converted to 2006 US dollars. RESULTS Of 58,376 presumed nosocomial infections, 12,578 (21.6%) were identified as BSIs. More than 50% of BSIs occurred within the first week of hospitalization and 80% during the first 2 weeks. Various analyses resulted in the following estimates of BSI-associated incremental costs: basic regression analysis,
Archive | 2014
Ning Zheng; Stephen E. Brossette; Patrick A. Hymel; Daisy Y. Wong
19,643 (P < .0001; 95% confidence interval [CI]: