The aetiology of infections: The significance for hospital management.

Background: Skin and soft tissue infections are among the most prevalent infections requiring medical intervention, with abscesses being a clinically important subset. Identification of a causative organism is useful for clinical decision-making and tailoring infection management. The extent to which causative agents are reflected in clinical coding data has been grossly understudied, despite its importance for statistical and financial purposes. Methods: An audit of admissions to a London hospital, between 1 September 2014 and 31 August 2016, was performed. Analysis was undertaken to identify whether the discharge documentation, clinical coding reports and microbiological results showed concordance in the detailing of causative organisms associated with abscesses. The impact of incongruity on hospital management was reviewed. Results: Of 664 admissions, 309 (46.5%) did not have a microbial swab taken at the site of the abscess. 164 (24.7%) of the admissions had positive results for one or more causative agents. Of these cases, 135 (82.3%) did not have the determined agents captured in the clinical coding reports. Capturing absent agents in the coding reports resulted in 120 Healthcare Resource Group (HRG) changes. Amendments culminated in a 77.1% uplift in total financial reimbursement of £104 190. Conclusion: Causative agents were not consistently recorded in the coding reports for admissions requiring abscess management. Omission carries negative implications for epidemiology, public health planning and financial reimbursement. [ABSTRACT FROM AUTHOR]