Is Nonpayment Effective in Decreasing Rates of Hospital-Acquired Infections?
Is Nonpayment Effective in Decreasing Rates of Hospital-Acquired Infections?
Lee GM, Kleinman K, Soumerai SB, et al
N Engl J Med. 2012;367:1428-1437
In 2008, reimbursement rates in the United States were altered for certain hospital-acquired infections that were deemed to be preventable. Did this policy change have any impact on hospital infection rates? Using Medicare and Medicaid data from 398 hospitals, the authors compared infection rates before and after the new policy for targeted infections (ie, central line infection and urinary infections linked to catheters) and nontargeted infections (ie, ventilator-associated pneumonia). Infection rates for central line infection, urinary catheter infection, and ventilator-associated pneumonia remained essentially unchanged after the new reimbursement rules took effect.
It is surprising that this large study of common hospital-acquired infections failed to show any impact of reducing financial reimbursement for hospital-acquired infections. The authors suggested several reasons for this, including altered hospital coding practices and the small amount of financial disincentive. With health costs in the United States at such high levels, financial disincentives will continue to be popular methods of trying to reduce health expenditures. An important message from this report is that we need continued monitoring of new legislation aimed at cutting healthcare costs to be sure that it is effective.
Abstract
Effect of Nonpayment for Preventable Infections in U.S. Hospitals
Lee GM, Kleinman K, Soumerai SB, et al
N Engl J Med. 2012;367:1428-1437
Summary
In 2008, reimbursement rates in the United States were altered for certain hospital-acquired infections that were deemed to be preventable. Did this policy change have any impact on hospital infection rates? Using Medicare and Medicaid data from 398 hospitals, the authors compared infection rates before and after the new policy for targeted infections (ie, central line infection and urinary infections linked to catheters) and nontargeted infections (ie, ventilator-associated pneumonia). Infection rates for central line infection, urinary catheter infection, and ventilator-associated pneumonia remained essentially unchanged after the new reimbursement rules took effect.
Viewpoint
It is surprising that this large study of common hospital-acquired infections failed to show any impact of reducing financial reimbursement for hospital-acquired infections. The authors suggested several reasons for this, including altered hospital coding practices and the small amount of financial disincentive. With health costs in the United States at such high levels, financial disincentives will continue to be popular methods of trying to reduce health expenditures. An important message from this report is that we need continued monitoring of new legislation aimed at cutting healthcare costs to be sure that it is effective.
Abstract