More on Quality and Safety

Hospital-acquired infections keep rising, wasting billions, finds Leapfrog

The percentage of hospitals achieving zero infections has declined dramatically since 2015, indicating many patients are still at risk.

Jeff Lagasse, Associate Editor

Each day, one out of 25 patients in the U.S. contracts a hospital-acquired infection resulting in billions of wasted dollars and an eye-popping 90,000 deaths annually. A new report published by The Leapfrog Group shows that the percentage of hospitals achieving zero infections has declined dramatically since 2015, indicating many patients are still at risk. 

Delivering quality care has become even more essential for hospitals and health systems since Medicare started issuing penalties for high rates of hospital-acquired conditions -- things like falls, ulcers and infections that could well have been avoided. Statistics from last year underscore this importance: In 2017, Medicare penalized 751 hospitals and health systems for that very reason with a 1 percent reduction in reimbursement rates for 2018. 

Leapfrog found that hospital-acquired infections are rising across all five examined in the survey, including central line associated bloodstream infections (CLABSI), catheter associated urinary tract infections (CAUTI), surgical site infection after colon surgery (SSI: Colon), methicillin-resistant staphylococcus aureus (MRSA), and clostridium difficile (C. diff).

"Given this disturbing trend in performance showing hospitals making less progress on the spread of healthcare-associated infections, it's concerning that the Centers for Medicare and Medicaid Services is proposing to decrease public reporting and transparency around infection rates and other measures of problems in hospitals," said Leah Binder, president and CEO of Leapfrog. "We urge all consumers to join with us in advocating for CMS to reconsider these changes."

CMS recently issued its proposed rule for the Fiscal Year 2019 Inpatient Prospective Payment System. Among the proposed changes is removal of healthcare-associated infections from the Hospital Inpatient Quality Reporting program.

CMS often consolidates the data from multiple facilities under a single Medicare Provider Number, or MPN. The report also found hospitals that report as part of the same health system under the same MPN sometimes perform significantly differently on preventing infections.

Encouragingly, the report's findings showed the majority of reporting hospitals had fewer infections than would be expected according to the Centers for Disease Control and Prevention's Standardized Infection Ratio methodology. SIRs compare the actual number of infections reported to what CDC would have predicted for that facility, given various facility and/or patient-level factors. 

A SIR of 1.0 means the number of HAIs is exactly what the CDC would have expected. Less than 1.0 means there were fewer HAIs than predicted; a SIR higher than 1.0 indicates more HAIs than the CDC would have predicted. The majority of hospitals reporting to the 2017 Survey had a SIR between 0.001 and 1.0 for each of the five HAIs examined.

Twitter: @JELagasse
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