Donker, T;
Smieszek, T;
Henderson, KL;
Walker, TM;
Hope, R;
Johnson, AP;
Woodford, N;
... Robotham, JV; + view all
(2019)
Using hospital network-based surveillance for antimicrobial resistance as a more robust alternative to self-reporting.
PLOS ONE
, 14
(7)
, Article e0219994. 10.1371/journal.pone.0219994.
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Abstract
Hospital performance is often measured using self-reported statistics, such as the incidence of hospital-transmitted micro-organisms or those exhibiting antimicrobial resistance (AMR), encouraging hospitals with high levels to improve their performance. However, hospitals that increase screening efforts will appear to have a higher incidence and perform poorly, undermining comparison between hospitals and disincentivising testing, thus hampering infection control. We propose a surveillance system in which hospitals test patients previously discharged from other hospitals and report observed cases. Using English National Health Service (NHS) Hospital Episode Statistics data, we analysed patient movements across England and assessed the number of hospitals required to participate in such a reporting scheme to deliver robust estimates of incidence. With over 1.2 million admissions to English hospitals previously discharged from other hospitals annually, even when only a fraction of hospitals (41/155) participate (each screening at least 1000 of these admissions), the proposed surveillance system can estimate incidence across all hospitals. By reporting on other hospitals, the reporting of incidence is separated from the task of improving own performance. Therefore the incentives for increasing performance can be aligned to increase (rather than decrease) screening efforts, thus delivering both more comparable figures on the AMR problems across hospitals and improving infection control efforts.
| Type: | Article |
|---|---|
| Title: | Using hospital network-based surveillance for antimicrobial resistance as a more robust alternative to self-reporting |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1371/journal.pone.0219994 |
| Publisher version: | https://doi.org/10.1371/journal.pone.0219994 |
| Language: | English |
| Additional information: | © 2019 Donker et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10078418 |
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