American Journal of Epidemiology Vol. 121, No. 2: 168-181
Copyright © 1985 by The Johns Hopkins University School of Hygiene and Public Health
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INCREASED RECOGNITION OF INFECTIOUS DISEASES IN US HOSPITALS THROUGH INCREASED USE OF DIAGNOSTIC TESTS, 1970–1976
1Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, Public Health Service, US Department of Health and Human Services Atlanta, GA
Address for reprints: SENIC Project, 
Public Inquiries Office, Centers for Disease Control, Atlanta, GA 30333
To assess the influence of physicians' diagnostic practices on the recognition of nosocomial infections, the authors analyzed data collected on 339,044 patients selected randomly from admissions in 1970 and 1975–1976 to 338 randomly selected hospitals representative of all acute-care US hospitals. Eight rates representing the frequency of cuftures or chest x-rays among patients with or without signs of infection were calculated. These varied widely among hospitals, were highest in teaching hospitals and in the Northeast, but increased more among small hospitals and in the South and West. Rates of performing urine cuftures and reporting colony counts were highly correlated with observed rates of nosocomial urinary tract infection. Analogous measures were moderately correlated with observed bacteremia rates and pneumonia rates but were only weakly associated with surgical wound infection rates. These data indicate that the nationwide increase in the use of these diagnostic tests increased the recognition of infectious diseases in US hospitals.
cost control; costs and cost analysis; cross infection; diagnosis; diagnosis, laboratory; health services research; infection
2Current address:Division of Epidemiology and Preventive Medicine, Department of Internal Medicine, Southwestern Medical School, University of Texas Health Science Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX
3Current address: Department of Internal Medicine, University of Washington School of Medicine, Harborview Medical Center, 6010 43rd Street, NE, Seattle, WA
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