{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:46:54Z","timestamp":1790704014471,"version":"4.1.0"},"reference-count":15,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":1523,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:sec id=\"S0195941700029672_abs1\"><jats:title>Background.<\/jats:title><jats:p>Assessments of infectious disease spread in hospitals seldom account for interfacility patient sharing. This is particularly important for pathogens with prolonged incubation periods or carrier states.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700029672_abs2\"><jats:title>Methods.<\/jats:title><jats:p>We quantified patient sharing among all 32 hospitals in Orange County (OC), California, using hospital discharge data. Same-day transfers between hospitals were considered \u201cdirect\u201d transfers, and events in which patients were shared between hospitals after an intervening stay at home or elsewhere were considered \u201cindirect\u201d patient-sharing events. We assessed the frequency of readmissions to another OC hospital within various time points from discharge and examined interhospital sharing of patients with <jats:italic>Clostridium difficile<\/jats:italic> infection.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700029672_abs3\"><jats:title>Results.<\/jats:title><jats:p>In 2005, OC hospitals had 319,918 admissions. Twenty-nine percent of patients were admitted at least twice, with a median interval between discharge and readmission of 53 days. Of the patients with 2 or more admissions, 75% were admitted to more than 1 hospital. Ninety-four percent of interhospital patient sharing occurred indirectly. When we used 10 shared patients as a measure of potential interhospital exposure, 6 (19%) of 32 hospitals \u201cexposed\u201d more than 50% of all OC hospitals within 6 months, and 17 (53%) exposed more than 50% within 12 months. Hospitals shared 1 or more patient with a median of 28 other hospitals. When we evaluated patients with C. <jats:italic>difficile<\/jats:italic> infection, 25% were readmitted within 12 weeks; 41% were readmitted to different hospitals, and less than 30% of these readmissions were direct transfers.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700029672_abs4\"><jats:title>Conclusions.<\/jats:title><jats:p>In a large metropolitan county, interhospital patient sharing was a potential avenue for transmission of infectious agents. Indirect sharing with an intervening stay at home or elsewhere composed the bulk of potential exposures and occurred unbeknownst to hospitals.<\/jats:p><\/jats:sec>","DOI":"10.1086\/656747","type":"journal-article","created":{"date-parts":[[2010,9,28]],"date-time":"2010-09-28T16:19:11Z","timestamp":1285690751000},"page":"1160-1169","source":"Crossref","is-referenced-by-count":70,"title":["Quantifying Interhospital Patient Sharing as a Mechanism for Infectious Disease Spread"],"prefix":"10.1017","volume":"31","author":[{"given":"Susan S.","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taliser R.","family":"Avery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeohan","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen R.","family":"Elkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher C.","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra K.","family":"Nutter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaka A.","family":"Nafday","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curtis J.","family":"Condon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Chrest","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Boos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgiy","family":"Bobashev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Wheaton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven A.","family":"Frank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Piatt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Lipsitch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin M.","family":"Bush","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Eubank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald S.","family":"Burke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce Y.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2015,1,2]]},"reference":[{"key":"S0195941700029672_ref006","volume-title":"Program and asbtracts of the 18th Annual Scientific Meeting of the Society of Healthcare Epidemiology of America","author":"Robotham","year":"2008"},{"key":"S0195941700029672_ref008","doi-asserted-by":"publisher","DOI":"10.1086\/649222"},{"key":"S0195941700029672_ref015","doi-asserted-by":"publisher","DOI":"10.1086\/593955"},{"key":"S0195941700029672_ref011","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2007.10.009"},{"key":"S0195941700029672_ref007","doi-asserted-by":"publisher","DOI":"10.1086\/651706"},{"key":"S0195941700029672_ref001","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200105103441903"},{"key":"S0195941700029672_ref003","doi-asserted-by":"publisher","DOI":"10.1080\/17441690701438128"},{"key":"S0195941700029672_ref002","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00367-08"},{"key":"S0195941700029672_ref010","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00315-07"},{"key":"S0195941700029672_ref014","doi-asserted-by":"publisher","DOI":"10.1086\/502539"},{"key":"S0195941700029672_ref005","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0510077103"},{"key":"S0195941700029672_ref004","doi-asserted-by":"publisher","DOI":"10.3201\/eid1005.030791"},{"key":"S0195941700029672_ref012","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2009.01.001"},{"key":"S0195941700029672_ref013","doi-asserted-by":"publisher","DOI":"10.1086\/592981"},{"key":"S0195941700029672_ref009","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39525.579063.BE"}],"container-title":["Infection Control &amp; 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