Early intervention by infectious diseases specialists saves lives, reduces costs

September 27, 2013

In a first-of-its-kind study to evaluate the impact of a medical specialty on patient outcomes, researchers found that hospitalized patients with severe infections such as meningitis and Clostridium difficile (C. diff.) are significantly less likely to die if they receive care from an infectious diseases specialist. The study, which analyzed nearly 130,000 Medicare patient cases, is now available online and will be published in the December 15 issue of Clinical Infectious Diseases.

According to the data, researchers at Avalere Health and the Infectious Diseases Society of America (IDSA) found that patients treated by infectious diseases (ID) specialists are 9 percent less likely to die in the hospital and 12 percent less likely to die after discharge. When an ID physician is consulted, patients experience an average 3.7 percent fewer days in an intensive care unit. The study also found that consultation with an ID specialist reduces the likelihood patients will be readmitted to the hospital within 30 days.

"Infectious diseases are the second leading cause of death worldwide. In an age where healthcare-acquired infections are linked to payment penalties and bundled payments leave little room for error, the impact of ID physicians is more critical than ever in providing high quality care," said Steven K. Schmitt, MD, FIDSA, chair of the IDSA's Clinical Affairs Committee, an ID physician at Cleveland Clinic and lead author of the study. "As the 'detectives' of the medical world, ID specialists have additional years of training and possess the expertise to quickly identify and treat potentially life-threatening infections."

In the study, researchers looked at a sample of Medicare patients who were hospitalized between Jan. 1, 2008 and Dec. 31, 2009 and had at least one of 11 serious but commonly treated infections: bacteremia, C. diff., central line associated bloodstream infections (CLABSI), bacterial endocarditis, human immunodeficiency virus (HIV)/opportunistic infections, meningitis, osteomyelitis, prosthetic joint infections, septic arthritis, septic shock, and vascular device infections. Matching patient characteristics, researchers compared the outcomes of 61,680 cases in which a hospitalized patient saw an ID specialist to 65,192 cases that did not involve an ID specialist.

The benefits of ID consultation are more pronounced when patients are seen earlier, researchers note. Patients seen by an ID physician within two days of being admitted to the hospital are 6 percent less likely to be readmitted to the hospital within 30 days of discharge compared to patients seen by an ID physician after the first two days. These patients also have an average 3.8 percent fewer days in the hospital, and their total Medicare costs are nearly 6.2 percent lower in the 30 days after discharge from the hospital.

"These findings are in line with healthcare reform efforts being implemented through the Affordable Care Act, which shows that including ID specialists in up-front care of patients provides better outcomes at lower costs," said Daniel McQuillen, MD, FIDSA, a member of the Infectious Diseases Society of America, ID physician at Lahey Hospital & Medical Center and study author. "Further, the association of ID specialist involvement with reduced readmission rates suggests an important role for the ID physician in transitions of care from the hospital to the community."

Explore further: Physician continuity after patients leave hospital for heart failure can help survival rates

Related Stories

Physician continuity after patients leave hospital for heart failure can help survival rates

August 19, 2013
Patients with heart failure who see a physician in the first month after leaving hospital are more likely to survive than those who do not see a doctor, reports a new study in CMAJ (Canadian Medical Association Journal). ...

Relationship of medical interventions in childhood and prevalence of later intellectual disability

April 29, 2013
A study by Jeffrey P. Brosco, M.D., Ph.D., of the University of Miami, Florida, and colleagues examines the relationship between medical interventions in early childhood and the increasing prevalence of later intellectual ...

Low dose antibiotic treatment of C-difficile as effective as high dose in hospital setting

September 11, 2013
Clostridium difficile infection (CDI) treatment in a hospital setting using low dose oral vancomycin showed similar effectiveness compared to high dose, according to a new study by researchers at Montefiore Medical Center ...

HF patients treated by a cardiologist, rather than hospitalist, have fewer readmissions

November 6, 2012
When a cardiologist attends to heart failure patients, even when the severity of illness is higher, patients have reduced rates of hospital readmissions, compared with those patients who are treated by a hospitalist, according ...

Bacterial infection's spread occurs beyond health care settings, study finds

September 25, 2013
(HealthDay)—A new British study raises questions about the transmission of Clostridium difficile, a bacteria that causes life-threatening diarrhea in people who have recently been on antibiotics.

Antibiotics prevent some hospital UTIs

June 21, 2013
(Medical Xpress)—Urinary tract infections are among the most common infections acquired in hospitals. Most are linked to catheters that drain urine from the bladder, providing a direct route for bacteria to enter.

Recommended for you

Finish your antibiotics course? Maybe not, experts say

July 27, 2017
British disease experts on Thursday suggested doing away with the "incorrect" advice to always finish a course of antibiotics, saying the approach was fuelling the spread of drug resistance.

Phase 3 trial confirms superiority of tocilizumab to steroids for giant cell arteritis

July 26, 2017
A phase 3 clinical trial has confirmed that regular treatment with tocilizumab, an inhibitor of interleukin-6, successfully reduced both symptoms of and the need for high-dose steroid treatment for giant cell arteritis, the ...

A large-scale 'germ trap' solution for hospitals

July 26, 2017
When an infectious airborne illness strikes, some hospitals use negative pressure rooms to isolate and treat patients. These rooms use ventilation controls to keep germ-filled air contained rather than letting it circulate ...

Researchers report new system to study chronic hepatitis B

July 25, 2017
Scientists from Princeton University's Department of Molecular Biology have successfully tested a cell-culture system that will allow researchers to perform laboratory-based studies of long-term hepatitis B virus (HBV) infections. ...

Male hepatitis B patients suffer worse liver ailments, regardless of lifestyle

July 25, 2017
Why men with hepatitis B remain more than twice as likely to develop severe liver disease than women remains a mystery, even after a study led by a recent Drexel University graduate took lifestyle choices and environments ...

Mind-body therapies immediately reduce unmanageable pain in hospital patients

July 25, 2017
Mindfulness training and hypnotic suggestion significantly reduced acute pain experienced by hospital patients, according to a new study published in the Journal of General Internal Medicine.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.