National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Events (2)
- Catheter-Associated Urinary Tract Infection (CAUTI) (2)
- Central Line-Associated Bloodstream Infections (CLABSI) (2)
- Critical Care (1)
- (-) Healthcare-Associated Infections (HAIs) (9)
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- Urinary Tract Infection (UTI) (2)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 9 of 9 Research Studies DisplayedArntson E, Dimick JB, Nuliyalu U
Changes in hospital-acquired conditions and mortality associated with the hospital-acquired condition reduction program.
This study evaluated changes in Hospital-Acquired Conditions (HACs) and 30-day mortality after the announcement of the Centers for Medicare and Medicare Services’ Hospital-Acquired Condition Reduction Program (HACRP) in August 2013. The authors evaluated models to test for changes in HACs and 30-day mortality before and after the Affordable Care Act (ACA), and after the HACRP. Fee-for-service Medicare claims from 2009 to 2015 were used. The HAC rate declined after the ACA was passed and declined further after the HACRP announcement. However, 30-day mortality rates were unchanged.
AHRQ-funded; HS026244.
Citation: Arntson E, Dimick JB, Nuliyalu U .
Changes in hospital-acquired conditions and mortality associated with the hospital-acquired condition reduction program.
Ann Surg 2021 Oct 1;274(4):e301-e07. doi: 10.1097/sla.0000000000003641..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Mortality, Medicare, Payment, Prevention, Patient Safety
Sankaran R, Gulseren B, Nuliyalu U R, Gulseren B, Nuliyalu U
A comparison of estimated cost savings from potential reductions in hospital-acquired conditions to levied penalties under the CMS Hospital-Acquired Condition Reduction Program.
The Hospital-Acquired Condition Reduction Program (HACRP) from the Centers for Medicare & Medicaid Services (CMS) reduces Medicare payments to hospitals with high rates of hospital-acquired conditions (HACs) by 1% each year. It is not known how the savings accruing to CMS from such penalties compare to savings resulting from a reduction in HACs driven by this program. This study compared the reported savings to CMS from financial penalties levied under the HACRP with savings resulting from potential reductions in HACs.
AHRQ-funded; HS000053; HS026244.
Citation: Sankaran R, Gulseren B, Nuliyalu U R, Gulseren B, Nuliyalu U .
A comparison of estimated cost savings from potential reductions in hospital-acquired conditions to levied penalties under the CMS Hospital-Acquired Condition Reduction Program.
Jt Comm J Qual Patient Saf 2020 Aug;46(8):438-47. doi: 10.1016/j.jcjq.2020.05.002.
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Keywords: Healthcare Costs, Healthcare-Associated Infections (HAIs), Hospitals, Patient Safety, Medicare
Hsu HE, Wang R, Broadwell C
Association between federal value-based incentive programs and health care-associated infection rates in safety-net and non-safety-net hospitals.
The authors assessed the association of Hospital-Acquired Condition Reduction Program (HACRP) and Hospital Value-Based Purchasing (HVBP) implementation with changes in rates of targeted health care-associated infections and disparities in rates among safety-net and non-safety-net hospitals. They found that HACRP and HVBP implementation was not associated with any improvements in targeted health care-associated infections among safety-net or non-safety-net hospitals or with changes in disparities in infection rates. They concluded that, given the persistent health care-associated infection rate disparities, these programs appear to function as a disproportionate penalty system for safety-net hospitals that offer no measurable benefits for patients.
AHRQ-funded; HS018414.
Citation: Hsu HE, Wang R, Broadwell C .
Association between federal value-based incentive programs and health care-associated infection rates in safety-net and non-safety-net hospitals.
JAMA Netw Open 2020 Jul;3(7):e209700. doi: 10.1001/jamanetworkopen.2020.9700..
Keywords: Healthcare-Associated Infections (HAIs), Hospitals, Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Medicare, Patient Safety
Sankaran R, Sukul D, Nuliyalu U
Changes in hospital safety following penalties in the US Hospital Acquired Condition Reduction Program: retrospective cohort study.
This study evaluated the association between hospital penalization in the US Hospital Acquired Condition Reduction Program (HACRP) and changes in clinical outcomes. Out of the total of 724 hospitals were penalized in fiscal year 2015, 708 were included in the study. The majority of the penalized hospitals were large teaching institutions and have a greater share of low-income patients than non-penalized hospitals. After penalization, there was a non-significant change in hospital acquired conditions, 30-day readmission rates, and 30-day mortality. This might mean that disparities in care could be exacerbated.
AHRQ-funded; HS026244.
Citation: Sankaran R, Sukul D, Nuliyalu U .
Changes in hospital safety following penalties in the US Hospital Acquired Condition Reduction Program: retrospective cohort study.
BMJ 2019 Jul 3;366:l4109. doi: 10.1136/bmj.l4109..
Keywords: Health Insurance, Healthcare-Associated Infections (HAIs), Hospitals, Medicare, Patient Safety, Provider Performance, Payment, Quality of Care, Quality Indicators (QIs)
Metersky ML, Eldridge N, Wang Y
AHRQ Author: Eldridge N
National trends in the frequency of bladder catheterization and physician-diagnosed catheter-associated urinary tract infections: results from the Medicare Patient Safety Monitoring System.
The researchers assessed bladder catheterization frequency (percentage of patients catheterized) and risk-adjusted catheter-associated urinary tract infection (CAUTI frequency (percentage of catheterized patients developing CAUTI) from 2009-2014. They found statistically significant declines in observed bladder catheterization frequency and adjusted CAUTI frequency in some patient populations between 2009 and 2014.
AHRQ-authored; AHRQ-funded; 290201200003C; HS019767; HS024385; HS018334.
Citation: Metersky ML, Eldridge N, Wang Y .
National trends in the frequency of bladder catheterization and physician-diagnosed catheter-associated urinary tract infections: results from the Medicare Patient Safety Monitoring System.
Am J Infect Control 2017 Aug;45(8):901-04. doi: 10.1016/j.ajic.2017.03.008.
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Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Urinary Tract Infection (UTI), Patient Safety, Adverse Events, Medicare
Vaz LE, Kleinman KP, Kawai AT
Impact of Medicare's hospital-acquired condition policy on infections in safety net and non-safety net hospitals.
The researchers sought 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. They found that this 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.
AHRQ-funded; HS018414.
Citation: Vaz LE, Kleinman KP, Kawai AT .
Impact of Medicare's hospital-acquired condition policy on infections in safety net and non-safety net hospitals.
Infect Control Hosp Epidemiol 2015 Jun;36(6):649-55. doi: 10.1017/ice.2015.38..
Keywords: Patient Safety, Medicare, Healthcare-Associated Infections (HAIs), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs)
Waters TM, Daniels MJ, Bazzoli GJ
Effect of Medicare's nonpayment for hospital-acquired conditions: lessons for future policy.
This study measured the association between Medicare’s nonpayment policy and 4 outcomes addressed by the Hospital-Acquired Conditions Initiative and found improvements in both the rates of central-line associated bloodstream infections and catheter-related urinary tract infections but no improvements for either hospital acquired pressure ulcers or injurious patient falls.
AHRQ-funded; HS020627
Citation: Waters TM, Daniels MJ, Bazzoli GJ .
Effect of Medicare's nonpayment for hospital-acquired conditions: lessons for future policy.
JAMA Intern Med. 2015 Mar;175(3):347-54. doi: 10.1001/jamainternmed.2014.5486..
Keywords: Quality of Care, Healthcare-Associated Infections (HAIs), Medicare, Patient Safety
Calderwood MS, Kleinman K, Bratzler DW
Medicare claims can be used to identify US hospitals with higher rates of surgical site infection following vascular surgery.
This study found that among Medicare patients who underwent vascular surgery at 2,512 U.S. hospitals, a patient undergoing surgery in a hospital ranked in the worst-performing decile based on claims had a 2.5 times greater likelihood of developing a chart-confirmed surgical site infection relative to a patient characteristics in a hospital in the best-performing decile.
AHRQ-funded; HS018878
Citation: Calderwood MS, Kleinman K, Bratzler DW .
Medicare claims can be used to identify US hospitals with higher rates of surgical site infection following vascular surgery.
Med Care. 2014 Oct;52(10):918-25. doi: 10.1097/MLR.0000000000000212..
Keywords: Medicare, Surgery, Healthcare-Associated Infections (HAIs), Patient Safety, Hospitals, Adverse Events
Eckenrode S, Bakullari A, Metersky ML
The association between age, sex, and hospital-acquired infection rates: results from the 2009-2011 National Medicare Patient Safety Monitoring System.
The researchers, using six different measures of hospital-acquired infections (HAIs), analyzed data from a large national sample of patients admitted to the hospital with acute cardiovascular disease, pneumonia, and major surgery to determine to determine age- and sex-related differences in HAI rates. They found that there are no simple ways to focus HAI-prevention efforts based solely on age or sex.
AHRQ-funded; 290201200003C
Citation: Eckenrode S, Bakullari A, Metersky ML .
The association between age, sex, and hospital-acquired infection rates: results from the 2009-2011 National Medicare Patient Safety Monitoring System.
Infect Control Hosp Epidemiol. 2014 Oct;35 Suppl 3:S3-9. doi: 10.1086/677831..
Keywords: Healthcare-Associated Infections (HAIs), Patient Safety, Medicare, Critical Care