Methicillin resistant staphylococcus aureus (MRSA), central line associated with blood stream infections (CLABSIs), catheter associated urinary tract infections (CAUTIs) and surgical site infections (SSIs) are health care associated infections (HAIs) which are a massive burden on the health care system. These issues are closely linked with reimbursement and outcomes. It is postulated that the spread of these health care associated infections is linked closely with mortality from sepsis.
De identified data about the number of board certified Infectious Disease (ID) physicians by zip code was obtained from the Doximity physician database. We then conducted a descriptive analysis using mortality data from the National Center for Health Statistics'(NCHS), Compressed Mortality File (CMF), which contains descriptive data on the age, race, sex, year and causes of all deaths in the US. We defined sepsis death as death attributed to an infection. In addition, the location of current ID fellowships was obtained from the National Residency Matching Program (NRMP) public data. These were mapped using Google fusion tables and the results compared to CDC databases: prevalence of MRSA, CLABSIs, CAUTIs and SSIs.
A total 147 fellowship programs and 7129 board certified physicians were identified in ID. Mortality from sepsis was highest in states: Arkansas, Louisiana, Mississippi, Tennessee, Kentucky, West Virginia and Florida, which correlated with the highest prevalence of MRSA, CLABSIs, CAUTIs and SSIs. ID fellowships and board certified physicians on the other hand tend to be concentrated on the East coast and the metropolitan cities of the West. Studies have also shown in the past that physicians tend to practice in geographical locations where they completed their training.
The use of this novel social network mapping approach to assess the Infectious Diseases physician workforce has the potential of providing real time data regarding their geographical spread. HAIs and mortality from sepsis tend to be higher in locations with fewer ID fellowships and board certified physicians. This problem could be addressed by rebalancing interventions and focussing on efforts to match the work force with the prevalence of HAIs and locations with higher sepsis mortality.