Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T12:49:25.648Z Has data issue: false hasContentIssue false

Impact of Hospital Operating Margin on Central Line–Associated Bloodstream Infections Following Medicare’s Hospital-Acquired Conditions Payment Policy

Published online by Cambridge University Press:  03 November 2015

Michael S. Calderwood*
Affiliation:
Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, Massachusetts Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
Louise E. Vaz
Affiliation:
Division of Pediatric Infectious Diseases, Doernbecher Children’s Hospital, Oregon Health & Science University, Portland, Oregon
Alison Tse Kawai
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
Robert Jin
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
Melisa D. Rett
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
Patricia S. Grant
Affiliation:
Methodist Hospital for Surgery, Addison, Texas Association for Professionals in Infection Control and Epidemiology, Washington, DC
Grace M. Lee
Affiliation:
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts Division of Infectious Diseases, Boston Children’s Hospital, Boston, Massachusetts.
*
Address correspondence to Michael S. Calderwood, MD, MPH, Brigham and Women’s Hospital, Division of Infectious Diseases, 181 Longwood Ave, MCP Bldg, 5th Fl, Boston, MA 02115 ([email protected]).

Abstract

In October 2008, Medicare ceased additional payment for hospital-acquired conditions not present on admission. We evaluated the policy’s differential impact in hospitals with high vs low operating margins. Medicare’s payment policy may have had an impact on reducing central line–associated bloodstream infections in hospitals with low operating margins.

Infect. Control Hosp. Epidemiol. 2015;37(1):100–103

Type
Concise Communications
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Centers for Medicare and Medicaid Services; Department of Health and Human Services. Medicare program: changes to the hospital inpatient prospective payment systems and fiscal year 2008 rates. Fed Regist 2007;72:4737947428.Google Scholar
2. Lee, GM, Kleinman, K, Soumerai, SB, et al. Effect of nonpayment for preventable infections in U.S. hospitals. N Engl J Med 2012;367:14281437.CrossRefGoogle ScholarPubMed
3. Vaz, LE, Kleinman, K, Kawai, AT, et al. Impact of Medicare's hospital-acquired condition policy on infections in safety net and non-safety net hospitals. Infect Control Hosp Epidemiol 2015;36:649655.Google Scholar
4. Ly, DP, Jha, AK, Epstein, AM. The association between hospital margins, quality of care, and closure or other change in operating status. J Gen Intern Med 2011;26:12911296.Google Scholar
5. Horan, TC, Andrus, M, Dudeck, MA. CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36:309332.Google Scholar
6. American Hospital Association (AHA). Annual Survey Database Fiscal Year 2009. Chicago: AHA, 2010.Google Scholar
7. Centers for Medicare and Medicaid Services; Department of Health and Human Services. CMS website. Healthcare cost report information system (HCRIS). https://www.cms.gov/Research-Statistics-Data-and-Systems/Downloadable-Public-Use-Files/Cost-Reports/index.html. Accessed June 23, 2015.Google Scholar
8. Hoff, T, Hartmann, CW, Palmer, JA, Wroe, P, Dutta-Linn, MM, Lee, G. The Medicare policy of payment adjustment for health care-associated infections: perspectives on potential unintended consequences. Med Care Res Rev 2012;69:4561.Google Scholar
9. Lee, GM, Hartmann, CW, Graham, D, et al. Perceived impact of the Medicare policy to adjust payment for health care-associated infections. Am J Infect Control 2012;40:314319.Google Scholar
10. Ayanian, JZ, Weissman, JS. Teaching hospitals and quality of care: a review of the literature. Milbank Q 2002;80:569593.Google Scholar
Supplementary material: File

Calderwood supplementary material S1

Calderwood supplementary material

Download Calderwood supplementary material S1(File)
File 14.9 KB
Supplementary material: File

Calderwood supplementary material S2

Calderwood supplementary material

Download Calderwood supplementary material S2(File)
File 12.7 KB