Hospital Isolation for Patients with Infectious Diseases?

July 11, 2017

Hospital Isolation for Patients with Infectious Diseases?

  1. Grace C. Huang, MD

Isolation for patients with respiratory illnesses and resistant staph infections is associated with longer stays and higher hospital costs.

  1. Grace C. Huang, MD

Mounting evidence shows that isolation precautions, which are intended to prevent spread of infectious disease, have many untoward consequences for patients, including less physical contact from healthcare providers, excess falls, pressure ulcers, psychological isolation, and lower patient satisfaction.

To examine the effect of isolation precautions, researchers retrospectively analyzed the administrative database of hospitalized medical patients at three academic medical centers in Toronto. A total of 1502 patients who received respiratory droplet precautions and 737 patients who received contact precautions for methicillin-resistant Staphylococcus aureus (MRSA) were propensity-matched (on comorbidities, demographics, and time spent in the hospital during the past 3 months) to >17,000 patients with no isolation precautions.

Investigators found that patients who were isolated for respiratory illnesses had significantly longer hospital stays than controls (8.5 vs. 7.6 days) and higher costs of care (C$7,194 vs. $6,294). Patients isolated for MRSA had significantly higher 30-day readmission rates (19% vs. 15%), longer stays (11.9 vs. 9.1 days), and higher costs of care ($11,009 vs. $7,670).

Comment

These results show that isolating patients to prevent spread of diseases might be harmful to some patients and might place an undue economic burden on hospitals. This study didn't clarify the benefits of isolation, because it didn't address whether isolation precautions improved overall infection control at these hospitals. Some institutions have abandoned contact precautions for MRSA and vancomycin-resistant enterococci because of the potential negative effects of isolation without clear evidence of benefit.

Editor Disclosures at Time of Publication

  • Disclosures for Grace C. Huang, MD at time of publication Equity Pfizer Grant / Research support National Cancer Institute; Donald Reynolds Foundation Editorial boards MedEdPORTAL; Simulation in Healthcare; Academic Medicine

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