Hospital report cards for hospital-acquired bedsores: How good are the grades?

The data Medicare uses to publicly report hospital rates of patients developing pressure ulcers (or bedsores) is not an accurate source for comparing hospitals on how well they prevent the condition, says a new University of Michigan study.

Bedsores are skin wounds often caused by pressure against the skin when staying in one position for too long. They are among many common hospital-acquired conditions Medicare's Hospital Compare website reports in an effort to help consumers compare the quality of their care at different hospitals.

Hospital bedsore rates varied widely based on how the data was collected, unfairly making some hospitals appear to fare better or worse than others, according to the findings that appear in the Annals of Internal Medicine.

"We found drastic differences in performance for bedsore rates depending on which type of data was reviewed – hospitals could be graded as either superior or below average depending on the type of data used," says lead author Jennifer Meddings, M.D., M.Sc., an assistant professor in the Department of Internal Medicine, Division of General Medicine at U-M Medical School.

"This raises significant concerns about how accurately hospitals are being compared to each other, as this information is reported to the public and may lead to financial penalties for hospitals that seem to be doing poorly."

Overall, bedsore rates were about 10 times lower when they were based on billing data compared to rates calculated from bedside exams by nurses. In bedside exams, trained teams of independent nurses record rates by periodically evaluating patients for through a comprehensive skin exam. In contrast, hospital-acquired cases are identified by hospital coders generating billing data based on how physicians and wound care teams describe wounds in their medical record notes.

"Our findings provide a strong case for removing rates for pressure ulcers from the Medicare's Hospital Compare website in order to prevent comparisons that may be misleading to patients and policymakers," Meddings says.

More information: Ann Intern Med, "Hospital Report Cards for Hospital-Acquired Pressure Ulcers: How Good are the Grades?" Oct.15, 2013; Volume 159, No.8

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

More aging boomers, but fewer doctors to care for them

1 hour ago

By 2030, the last of the Baby Boomer generation will have turned 65 years old, putting the population of "senior boomers" in the United States at approximately 71 million. Currently, only about 7,000 certified geriatricians – ...

UK study examines communication and end-of-life decisions

1 hour ago

For many people, talking about end-of-life decisions can be very difficult. Although making choices about health care at the end of life is an important outcome of these conversations, recent research suggests that talking ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.