Format

Send to

Choose Destination
Infect Control Hosp Epidemiol. 2015 Jun;36(6):649-55. doi: 10.1017/ice.2015.38. Epub 2015 Mar 3.

Impact of Medicare's Hospital-Acquired Condition policy on infections in safety net and non-safety net hospitals.

Author information

1
1Division of Pediatric Infectious Diseases,Doernbecher Children's Hospital,Oregon Health & Science University,Portland.
2
2Department of Population Medicine,Harvard Medical School & Harvard Pilgrim Health Care Institute,Boston,Massachusetts.
3
3Centers for Medicare and Medicaid Services,Boston,Massachusetts.
4
4Methodist Hospital for Surgery,Addison,Texas.
5
6Division of Infectious Diseases,Boston Children's Hospital,Boston,Massachusetts.

Abstract

BACKGROUND:

Policymakers may wish to align healthcare payment and quality of care while minimizing unintended consequences, particularly for safety net hospitals.

OBJECTIVE:

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.

DESIGN:

Interrupted time-series design.

SETTING AND PARTICIPANTS:

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.

RESULTS:

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 (P for 2-way interaction, .87).

CONCLUSIONS:

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.

PMID:
25732568
DOI:
10.1017/ice.2015.38
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Cambridge University Press
Loading ...
Support Center