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2010),"The adoption of technology orientation in healthcare delivery: Case study of a large-scale hospital and healthcare system's electronic health record", If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -Hospital-acquired infection (HAI) poses important health and financial problems for society. Understanding the causes of infection in hospital care is strategically important for hospital administration for formulating effective infection control programs. The purpose of this paper is to show that hospital length of stay (LOS) and the probability of developing an infection are interdependent. Design/methodology/approach -A two-equation model was specified for hospital LOS and the incidence of infection. Using the patient-level data of hospital discharge in the State of New Jersey merged with other data, the parameters of the two equations were estimated using a simultaneous estimation method. Findings -It was found that extending the LOS by one day increases the probability of catching an infection by 1.37 percent and the onset of infection increases average LOS by 9.32 days. The estimation indicates that HAI elongates LOS increasing the cost of a hospital stay.Research limitations/implications -The findings imply that studies on cost of HAI that do not properly control for the simultaneity of these two variables, will result in a biased estimation of cost. Originality/value -The study produces quantitative estimation of the extent of interdependency of hospital LOS and the probability of catching an infection.

The authors assessed the costs of hospital-acquired infections using rigorous econometric methods on publicly available data, controlling for the interdependency of length of stay and the incidence of hospital acquired infection, and estimated the cost shares of different payers. They developed a system of equations involving length of stay, incidence of infection, and the total hospital care cost to be estimated using simultaneous equations system. The main data came from the State of New Jersey UB 92 for 2004, complimented with data from the Annual Survey of Hospitals by the American Hospital Association and the Medicare Cost Report of 2004. The authors estimated that an incidence of hospital acquired infection increases the hospital care cost of a patient by $10,375 and it increases the length of stay by 3.30 days, and that a disproportionately higher portion of the cost is attributable to Medicare. They conclude that reliable cost estimates of hospital-acquired infections can be made using publicly available data. Their estimate shows a much larger aggregate cost of $16.6 billion as opposed to $5 billion reported by the Centers for Disease Control and Prevention but much less than $29 billion as reported elsewhere in the literature.

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