Featured Research

from universities, journals, and other organizations

Common hospital-acquired infection rarely reported in the dataset used to implement hospital penalties

Date:
September 5, 2012
Source:
University of Michigan Health System
Summary:
Aiming to cut expenses and improve care, a 2008 Medicare policy stopped paying hospitals extra to treat some preventable, hospital-acquired conditions -- including urinary tract infections (UTIs) in patients after bladder catheters are placed. But a statewide Michigan analysis shows there was very little change in hospital payment due to removing pay for hospital-acquired catheter-associated UTIs. For all adult hospital stays in Michigan in 2009, eliminating payment for this infection decreased hospital pay for only 25 hospital stays (0.003 percent of all stays). This is in great contrast to the large savings anticipated, given that this condition accounts for nearly one third of all hospital-acquired infections.

Aiming to cut expenses and improve care, a 2008 Medicare policy stopped paying hospitals extra to treat some preventable, hospital-acquired conditions -- including urinary tract infections (UTIs) in patients after bladder catheters are placed.

Related Articles


But a statewide analysis by the University of Michigan shows there was very little change in hospital payment due to removing pay for hospital-acquired catheter-associated UTIs. For all adult hospital stays in Michigan in 2009, eliminating payment for this infection decreased hospital pay for only 25 hospital stays (0.003 percent of all stays). This is in great contrast to the large savings anticipated, given that this condition accounts for nearly one third of all hospital-acquired infections.

The reason, U-M authors say, is that the "no-pay" policy uses billing data that is inaccurate for identifying such complications.

The findings were published in the Annals of Internal Medicine, alongside an editorial that emphasizes the national policy implications of the U-M findings. U-M's analysis, the editorial says, argues that careful dataset selection is crucial when used to measure and penalize hospital performance.

"We think the policy was well intended but its financial savings from non-payment for catheter-associated UTI are negligible because of the data used to implement the policy," says lead author Jennifer Meddings, MD, MSc, an assistant professor in the Department of Internal Medicine, Division of General Medicine at U-M Medical School.

The problem, authors say, is that the policy relies on claims data previously used only for billing -- but multiple billing codes must be listed correctly to indicate that a UTI is due to a catheter and occurred only after admission to the hospital. As a result, most cases are listed as simple UTIs and hospitals continue receiving payment as usual.

"If the cases you wish to penalize are not documented in the dataset chosen, the policy's intended impact will be limited," Meddings notes.

But the blame doesn't fall on billing coders who generate the claims data, authors say, as coders can only list the diagnoses as described by physicians in the medical record (following federal guidelines.)

Meanwhile, the well-publicized policy implemented by the Centers for Medicare and Medicaid Services has expanded to include more hospital-acquired conditions for nonpayment, such as pressure ulcers (or bed sores). But the authors warn that similar coding problems with other conditions may also stymie financial savings.

"We don't have any evidence on whether it has prompted hospitals to improve patient care to prevent these infections, but we do know that it did not lead to large financial savings," Meddings says.

The findings suggest that billing data is inaccurate for comparing hospitals by their catheter-associated UTI rates. Because billing data is anticipated to be used in 2015 to penalize hospitals with the highest infection rates, authors say, hospitals that report accurately in claims data will be unfairly penalized because their reported rates will be higher.


Story Source:

The above story is based on materials provided by University of Michigan Health System. Note: Materials may be edited for content and length.


Journal Reference:

  1. Jennifer A. Meddings, Heidi Reichert, Mary A.M. Rogers, Sanjay Saint, Joe Stephansky, Laurence F. McMahon, Jr. Effect of Nonpayment for Hospital-Acquired, Catheter-Associated Urinary Tract InfectionA Statewide Analysis. Annals of Internal Medicine, 2012; Sep; 157 (5): 305-312 [link]

Cite This Page:

University of Michigan Health System. "Common hospital-acquired infection rarely reported in the dataset used to implement hospital penalties." ScienceDaily. ScienceDaily, 5 September 2012. <www.sciencedaily.com/releases/2012/09/120905122752.htm>.
University of Michigan Health System. (2012, September 5). Common hospital-acquired infection rarely reported in the dataset used to implement hospital penalties. ScienceDaily. Retrieved December 19, 2014 from www.sciencedaily.com/releases/2012/09/120905122752.htm
University of Michigan Health System. "Common hospital-acquired infection rarely reported in the dataset used to implement hospital penalties." ScienceDaily. www.sciencedaily.com/releases/2012/09/120905122752.htm (accessed December 19, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Friday, December 19, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Kids Die While Under Protective Services

Kids Die While Under Protective Services

AP (Dec. 18, 2014) As part of a six-month investigation of child maltreatment deaths, the AP found that hundreds of deaths from horrific abuse and neglect could have been prevented. AP's Haven Daley reports. (Dec. 18) Video provided by AP
Powered by NewsLook.com
Dads-To-Be Also Experience Hormone Changes During Pregnancy

Dads-To-Be Also Experience Hormone Changes During Pregnancy

Newsy (Dec. 18, 2014) A study from University of Michigan researchers found that expectant fathers see a decrease in testosterone as the baby's birth draws near. Video provided by Newsy
Powered by NewsLook.com
Prenatal Exposure To Pollution Might Increase Autism Risk

Prenatal Exposure To Pollution Might Increase Autism Risk

Newsy (Dec. 18, 2014) Harvard researchers found children whose mothers were exposed to high pollution levels in the third trimester were twice as likely to develop autism. Video provided by Newsy
Powered by NewsLook.com
UN: Up to One Million Facing Hunger in Ebola-Hit Countries

UN: Up to One Million Facing Hunger in Ebola-Hit Countries

AFP (Dec. 17, 2014) Border closures, quarantines and crop losses in West African nations battling the Ebola virus could lead to as many as one million people going hungry, UN food agencies said on Wednesday. Duration: 00:52 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins