Impact of Medicare's Hospital-Acquired Condition Policy on Infections in Safety Net and Non–Safety Net Hospitals. (3rd March 2015)

• Record Type: Journal Article
• Authors: Vaz, Louise Elaine; Kleinman, Kenneth P.; Kawai, Alison Tse; Jin, Robert; Kassler, William J.; Grant, Patricia S.; Rett, Melisa D.; Goldmann, Donald A.; Calderwood, Michael S.; Soumerai, Stephen B.; Lee, Grace M.
• Is Part Of: Infection control and hospital epidemiology. Volume 36:Number 6(2015)
• Page Start: 649
• Page End: 655
• Publication Date: 2015-03-03
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2015.38
• Languages: English
• ISSNs: 0899-823X

Abstract

<abstract abstract-type="normal"> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec id="abs1" sec-type="general"> <title>BACKGROUND</title> <p>Policymakers may wish to align healthcare payment and quality of care while minimizing unintended consequences, particularly for safety net hospitals.</p> </sec> <sec id="abs2" sec-type="general"> <title>OBJECTIVE</title> <p>To determine whether the 2008 Centers for Medicare and Medicaid Services Hospital-Acquired Conditions policy had a differential impact on targeted healthcare-associated infection rates in safety net compared with non–safety net hospitals.</p> </sec> <sec id="abs3" sec-type="general"> <title>DESIGN</title> <p>Interrupted time-series design.</p> </sec> <sec id="abs4" sec-type="general"> <title>SETTING AND PARTICIPANTS</title> <p>Nonfederal acute care hospitals that reported central line–associated bloodstream infection and ventilator-associated pneumonia rates to the Centers for Disease Control and Prevention's National Health Safety Network from July 1, 2007, through December 31, 2013.</p> </sec> <sec id="abs5" sec-type="results"> <title>RESULTS</title> <p>We did not observe changes in the slope of targeted infection rates in the postpolicy period compared with the prepolicy period for either safety net (postpolicy vs prepolicy ratio, 0.96 [95% CI, 0.84–1.09]) or non–safety net (0.99 [0.90–1.10]) hospitals. Controlling for prepolicy secular trends, we did not detect differences in an immediate change at the time of the policy between safety net and non–safety net hospitals (<italic>P</italic> for 2-way interaction, .87).</p> </sec> <sec id="abs6" sec-type="conclusions"> <title>CONCLUSIONS</title> <p>The Centers for Medicare and Medicaid Services Hospital-Acquired Conditions policy did not have an impact, either positive or negative, on already declining rates of central line–associated bloodstream infection in safety net or non–safety net hospitals. Continued evaluations of the broad impact of payment policies on safety net hospitals will remain important as the use of financial incentives and penalties continues to expand in the United States.</p> <p> <italic>Infect Control Hosp Epidemiol</italic> 2015;00(0): 1–7</p> </sec> </abstract>