Abstract
BACKGROUND: Quantifying the relative burden of infections among hospitalizations from nursing home residents can inform prevention strategies. [Figure: see text] [Figure: see text] METHODS: We used MedPAR files to identify Medicare claims for unplanned inpatient hospital admissions. We included all hospitalizations with an admission date during or within one day of a nursing home stay (identified using assessments in the Minimum Dataset 3.0). We categorized infection-related hospitalizations by type using the primary diagnosis code, similar to a Medicare skilled nursing facility quality measure, healthcare-associated infections requiring hospitalization. We described the remaining non-infection hospitalizations using Major Diagnostic Categories (MDCs). Resident age, sex, hospitalization costs, and other characteristics were compared among those with infection-related and non-infection hospitalizations using chi-square and Wilcoxon rank-sum tests. RESULTS: We identified 706,875 hospital admissions among 494,611 nursing home residents in 2022. Among these, 286,446 (41%) had a primary diagnosis of an infection. The most frequent infection-related categorizations included sepsis (n=173,013, 60%), respiratory (n=53,288, 19%), device-related (n=28436, 10%), and genitourinary infections (n=23,089, 8%) (Figure 1). Of the non-infection hospitalizations, the most common MDCs were diseases and disorders of the circulatory (n=84,890, 20%), digestive (n=52,174, 12%), respiratory (n=52,021, 12%), and nervous systems (n=50,893, 12%) (Figure 2). For all hospital admissions, the mean beneficiary age was 77 years, 393,562 (56%) were females, and 301,460 (43%) had been hospitalized within the previous 30 days. Hospitalizations with a primary diagnosis of an infection had a longer median length of stay (6 vs 5 days), higher median claim cost ($10,905 vs $8,051), a higher proportion with intensive care unit admission (24% vs 12%), and higher proportion of death at discharge (14% vs 6%) than non-infection hospitalizations (all p< 0.001). CONCLUSION: Infection-related primary diagnoses constituted over 40% of all hospitalizations among nursing home residents and have increased morbidity and mortality. Prevention of infections among nursing home residents across healthcare settings may improve wellbeing. DISCLOSURES: All Authors: No reported disclosures