Medicare non-payment of hospital-acquired infections: infection rates three years post implementation.
Medicare Medicaid Res Rev
; 3(3)2013.
Article
em En
| MEDLINE
| ID: mdl-24753974
ABSTRACT
BACKGROUND:
Medicare ceased payment for some hospital-acquired infections beginning October 1, 2008, following provisions in the Medicare Modernization Act of 2003 and the Deficit Reduction Act of 2005.OBJECTIVE:
We examined the association of this policy with declines in rates of vascular catheter-associated infections (VCAI) and catheter-associated urinary tract infection (CAUTI). DATA Discharge data from the Florida Agency for Healthcare Administration from 2007 to 2011. STUDYDESIGN:
We compared rates of hospital-acquired vascular catheter-associated infections (HA-VCAI) and catheter-associated urinary tract infections (HA-CAUTI) before and after implementation of the new policy (January 2007 to September 2008 vs. October 2008 to September 2011). This pre-post, retrospective, interrupted time series study was further analyzed with a generalized hierarchical logistic regression, by estimating the probability of a patient acquiring these infections in the hospital, post-policy compared to pre-policy. PRINCIPALFINDINGS:
Pre-policy, 0.12% of admitted patients were diagnosed with CAUTI; of these, 32% were HA-CAUTI. Similarly, 0.24% of admissions were diagnosed as VCAI; of these, 60% were HA-VCAI. Post-policy, 0.16% of admissions were CAUTIs; of these, 31% were HA-CAUTI. Similarly, 0.3% of admissions were VCAIs and, of these, 45% were HA-VCAI. There was a statistically significant decrease in HA-VCAIs (OR 0.571 (p < 0.0001)) post-policy, but the reduction in HA-CAUTI (OR 0.968 (p < 0.4484)) was not statistically significant.CONCLUSIONS:
The results suggest Medicare non payment policy is associated with both a decline in the rate of hospital-acquired VCAI (HA-VCAI) per quarter, and the probability of acquiring HA-VCAI post- policy. The strength of the association could be overestimated, because of concurrent ongoing infection control interventions.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Infecção Hospitalar
/
Medicare
Tipo de estudo:
Prognostic_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Medicare Medicaid Res Rev
Ano de publicação:
2013
Tipo de documento:
Article