Medicare/Medicaid policy shift didn't budge hospital infection rates: study

October 10, 2012 by Alan Mozes, Healthday Reporter
Medicare/Medicaid policy shift didn't budge hospital infection rates: study
Researchers found rates started dropping before reimbursements for such infections were withdrawn.

(HealthDay)—A 2008 shift in Medicare/Medicaid policy that cut off reimbursements for costs related to preventable infections in hospitals did not improve infection rates, new research indicates.

The change, mandated by Congress, meant hospitals would no longer receive payments for the treatment of certain patient infections if they occurred after a patient was admitted for care.

The purpose of the new policy was to nudge hospitals into reining in the incidence of avoidable infections that included catheter-associated bloodstream and and ventilator-associated pneumonia.

But this new analysis, involving data collected from nearly 400 hospitals, revealed that a in such infections was actually under way well before the policy took effect.

"What we found basically was that infection rates have been steadily declining since 2006, but this financial penalty didn't actually add any benefit in terms of further reducing rates of infections," said study author Dr. Grace Lee, an associate professor with the Harvard Pilgrim Health Care Institute and Harvard Medical School in Boston "They were already going down both before and after the policy was implemented."

Lee and her colleagues discuss their findings in the Oct. 11 issue of the .

To gauge the impact of the policy change, the team sifted through the standardized surveillance records on in- that had been compiled by infection-control staff working at 400 acute care hospitals in 41 states. For the most part, the data covered the period from 2006 through 2011.

The result: The policy change appeared to have had no impact on the infections it was designed to target.

Why? The study authors suggested that a combination of factors, both positive and/or confusing, could be at play. On the one hand, they noted that other previous national and local efforts to bring down infection rates might have beat the new policy to the punch.

On the other hand, hospitals might have set out to implement more rigorous coding procedures once the policy took effect, such that more of an effort was made to better catch and log infections present at admission rather than catching them post-admission. If so, this could reflect the advent of improved administrative skills in hospitals, rather than better quality of care or patient safety.

Regardless of its true effect, Lee indicated that the new policy may have more broadly helped to keep the conversation about hospital infections front and center.

"National attention to prevention is an important thing in general," she said. "There's been a lot of attention paid to in hospitals, and it appears that all of these national, regional and local efforts [are] working. In terms of bringing increased attention to the issue, it's important in terms of getting hospital leadership attention."

"But no, in terms of actual patient outcomes, this particular penalty didn't improve the situation," Lee added.

Dr. Jeffrey Rothschild, an associate physician at Brigham and Women's Hospital in Boston, suggested that the findings are not unexpected.

"This is a really difficult thing to study, because often the data and discharge coding concerning hospital infections doesn't actually reflect what's really happening," Rothschild said. "But we do know there has been gradual improvement underway for some time in most hospitals in trying to reduce these kinds of infections, with an improved use of checklists and other interventions that hospitals have adopted."

"I'm not really surprised that they didn't find that the policy had a noticeable impact," Rothschild added. "However, I think the policy is sensible, and I think it's reasonable to continue it as a policy measure because the [new] is the result of growing literature showing that there are too many -acquired infections that are often quite preventable. It sends the right message to hospitals that if they haven't started to work on this issue yet, there is an incentive for them to do so."

Explore further: Medicare penalty appears to drive hospital infection prevention efforts

More information: For more on hospital infections, visit the U.S. Centers for Disease Control and Prevention.

Related Stories

Medicare penalty appears to drive hospital infection prevention efforts

May 1, 2012
The 2008 decision by the Centers for Medicare & Medicaid Services (CMS) to cease additional reimbursement to hospitals for certain healthcare-associated infections (HAIs) has led to enhanced focus on infection prevention ...

Hospital-acquired UTIs rarely reported in data used to implement penalties

September 5, 2012
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 ...

Few hospitals aggressively combat catheter-associated urinary tract infections

December 8, 2011
Hospitals are working harder than ever to prevent hospital-acquired infections, but a nationwide survey shows few are aggressively combating the most common one – catheter-associated urinary tract infections.

Hospitals that cooperate on infection control fare better than hospitals acting alone

October 9, 2012
An individual hospital's infection control efforts have a ripple effect on the prevalence of a deadly and highly infectious bacterium in hospitals throughout its surrounding region, a multi-center research group led by the ...

Recommended for you

Who uses phone apps to track sleep habits? Mostly the healthy and wealthy in US

January 16, 2018
The profile of most Americans who use popular mobile phone apps that track sleep habits is that they are relatively affluent, claim to eat well, and say they are in good health, even if some of them tend to smoke.

Improvements in mortality rates are slowed by rise in obesity in the United States

January 15, 2018
With countless medical advances and efforts to curb smoking, one might expect that life expectancy in the United States would improve. Yet according to recent studies, there's been a reduction in the rate of improvement in ...

Teens likely to crave junk food after watching TV ads

January 15, 2018
Teenagers who watch more than three hours of commercial TV a day are more likely to eat hundreds of extra junk food snacks, according to a report by Cancer Research UK.

Can muesli help against arthritis?

January 15, 2018
It is well known that healthy eating increases a general sense of wellbeing. Researchers at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) have now discovered that a fibre-rich diet can have a positive influence ...

Your dishwasher is not as sterile as you think

January 13, 2018
(HealthDay)—Your dishwasher may get those plates spotless, but it is also probably teeming with bacteria and fungus, a new study suggests.

Study reveals what sleep talkers have to say

January 12, 2018
A team of researchers with members from several institutions in France has conducted a study regarding sleep talking and has found that most sleep talking is not only negative in nature, but involves a large amount of swearing. ...

0 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.