Date of Conferral

2020

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Namgyal Kyulo

Abstract

Hospital acquired infections (HAIs) calls for the attention of public research because it allows for investigation of the health practices, resources, and barriers of different health facilities and their surrounding communities. This research study examined the relationship between hospital acquired clostridium difficile infection (CDI) and patient, socioeconomic, and hospital characteristics in the state of New Mexico to determine their correlation with the increased incidence of CDI between 2013 and 2015 and if significant differences exist. The research questions were explored with the implication of the fundamental cause model and the pathways model. New Mexico patients over the age of 18 and admitted to an acute care facility in 2014 and 2015 (n=186,669) were examined using a case-control, correlative, retrospective approach. The relationship between the study predictors: patient, socioeconomic, and hospital characteristics, and outcome variable, presence of a CDI diagnosis, was analyzed using a test of binomial logistic regression. Females (OR=1.31), Native Americans (OR=1.51), increase in age and number of diagnoses (OR=1.14; OR< 0.00), and increase in length of stay (OR=1.14) showed an increased likelihood of a CDI diagnosis. Medicaid users (OR=-0.63), income groups in the 4th quartile (OR=0.02), and surgical patients (OR=5.70) presented a significant association with the likelihood of a CDI diagnosis. The findings of the study address the social implication of how differences in health services, health resources, and financial barriers impact CDI prevention programs and if such impacts differ greatly across New Mexico jurisdictions and communities. There is a need to ensure that all New Mexico communities have standardized protocols and resources for CDI prevention.

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