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dc.contributor.authorLee, Grace M.
dc.contributor.authorKleinman, Kenneth Paul
dc.contributor.authorSoumerai, Stephen Bertram
dc.contributor.authorTse, Alison
dc.contributor.authorCole, David
dc.contributor.authorFridkin, Scott K.
dc.contributor.authorHoran, Teresa
dc.contributor.authorPlatt, Richard
dc.contributor.authorGay, Charlene
dc.contributor.authorKassler, William
dc.contributor.authorGoldmann, Donald Alan
dc.contributor.authorJernigan, John
dc.contributor.authorJha, Ashish Kumar
dc.date.accessioned2017-05-16T18:52:34Z
dc.date.issued2012
dc.identifier.citationLee, Grace M., Ken Kleinman, Stephen B. Soumerai, Alison Tse, David Cole, Scott K. Fridkin, Teresa Horan, et al. 2012. “Effect of Nonpayment for Preventable Infections in U.S. Hospitals.” New England Journal of Medicine 367 (15) (October 11): 1428–1437. doi:10.1056/nejmsa1202419.en_US
dc.identifier.issn0028-4793en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:32696162
dc.description.abstractBackground In October 2008, the Centers for Medicare and Medicaid Services (CMS) discontinued additional payments for certain hospital-acquired conditions that were deemed preventable. The effect of this policy on rates of health care–associated infections is unknown. Methods Using a quasi-experimental design with interrupted time series with comparison series, we examined changes in trends of two health care–associated infections that were targeted by the CMS policy (central catheter–associated bloodstream infections and catheter-associated urinary tract infections) as compared with an outcome that was not targeted by the policy (ventilator-associated pneumonia). Hospitals participating in the National Healthcare Safety Network and reporting data on at least one health care–associated infection before the onset of the policy were eligible to participate. Data from January 2006 through March 2011 were included. We used regression models to measure the effect of the policy on changes in infection rates, adjusting for baseline trends. Results A total of 398 hospitals or health systems contributed 14,817 to 28,339 hospital unit– months, depending on the type of infection. We observed decreasing secular trends for both targeted and nontargeted infections long before the policy was implemented. There were no significant changes in quarterly rates of central catheter– associated bloodstream infections (incidence-rate ratio in the postimplementation vs. preimplementation period, 1.00; P=0.97), catheter-associated urinary tract infections (incidence-rate ratio, 1.03; P=0.08), or ventilator-associated pneumonia (incidence-rate ratio, 0.99; P=0.52) after the policy implementation. Our findings did not differ for hospitals in states without mandatory reporting, nor did it differ according to the quartile of percentage of Medicare admissions or hospital size, type of ownership, or teaching status. Conclusions We found no evidence that the 2008 CMS policy to reduce payments for central catheter–associated bloodstream infections and catheter-associated urinary tract infections had any measurable effect on infection rates in U.S. hospitals.en_US
dc.language.isoen_USen_US
dc.publisherNew England Journal of Medicine (NEJM/MMS)en_US
dc.relation.isversionofdoi:10.1056/NEJMsa1202419en_US
dash.licenseLAA
dc.titleEffect of Nonpayment for Preventable Infections in U.S. Hospitalsen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalNew England Journal of Medicineen_US
dash.depositing.authorSoumerai, Stephen Bertram
dc.date.available2017-05-16T18:52:34Z
dc.identifier.doi10.1056/NEJMsa1202419*
dash.authorsorderedfalse
dash.contributor.affiliatedGoldmann, Donald
dash.contributor.affiliatedLee, Grace
dash.contributor.affiliatedPlatt, Richard
dash.contributor.affiliatedSoumerai, Stephen
dash.contributor.affiliatedJha, Ashish
dash.contributor.affiliatedKleinman, Kenneth Paul


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